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目的:应用meta分析比较瑞芬太尼静脉自控分娩镇痛与硬膜外分娩镇痛的效果。方法:利用计算机检索Pubmed、Web of Scince、Embase和The Cochrane Library等数据库，检索时间为建库至2018年12月，检索语种为英文。收集比较瑞芬太尼静脉自控分娩镇痛与硬膜外分娩镇痛效果的随机对照试验。评价指标包括：孕产妇中转剖宫产率、镇痛1 h时VAS评分、恶心、呕吐及瘙痒的发生率；新生儿出生1和5 min时的Apgar评分、脐血pH值。由2位研究员根据纳入与排除标准独立进行文献筛选、资料提取和质量评价后，采用RevMan 5.3软件进行meta分析。结果:最终纳入6篇文献，共1 578例孕产妇，其中瑞芬太尼静脉自控分娩镇痛组794例，硬膜外分娩镇痛组784例。与硬膜外分娩镇痛组相比，瑞芬太尼静脉自控分娩镇痛组孕产妇镇痛1 h时VAS评分、恶心、呕吐发生率的升高(n P0.05)。n 结论:虽然瑞芬太尼静脉自控分娩镇痛效果不如硬膜外分娩镇痛效果确切，但在严密监测下使用，不会对母婴造成不良影响。“,”Objective:To systematically review and compare the effects of patient-controlled intravenous labor analgesia with remifentanil and epidural labor analgesia.Methods:Databases such as Pubmed, Web of Scince, Embase and The Cochrane Library were searched using computers from inception to December 2018, with an English language restriction.The randomized controlled trials comparing the effects of patient-controlled intravenous labor analgesia with remifentanil and epidural labor analgesia were collected.Evaluation indexes included the rate of conversion to cesarean section and incidence of VAS scores, nausea and vomitting and pruritus at 1 h of analgesia; Apgar scores at 1 and 5 min after birth and pH value of umbilical cord blood.The literature screening, data extraction and quality evaluation were independently carried out based on the inclusion and exclusion criteria, and meta-analysis was conducted using the RevMan 5.3 software.Results:Six articles involving 1 578 parturients were finally included, with 794 cases in patient-controlled intravenous labor analgesia with remifentanil group and 784 cases in epidural labor analgesia group.Compared with epidural labor analgesia group, the incidence of VAS scores and nausea and vomitting at 1 h of analgesia was increased (n P0.05).n Conclusion:Although the effect of patient-controlled intravenous labor analgesia with remifentanil is not as accurate as that of epidural labor analgesia, it will not cause adverse effects on mothers and babies when used under close monitoring.