论文部分内容阅读
目的分析剖宫产术与脑性瘫痪发生率的关系,以降低脑性瘫痪的发病率和致残率。方法以(脑性瘫痪/脑瘫)和(病因/高危因素/剖腹产/剖宫产)等关键词及主题词对数据库包括中国期刊全文数据库(CNKI)、万方数据库、中国维普数据库(VIP)、PubMed数据库、MEDLINE数据库、OVID数据库、Cochrane图书馆循证医学评价数据库进行检索,检索时间为1990年1月1日-2016年4月1日。对纳入文献采用Review Manager5.2软件对符合条件的数据进行Meta分析,检验水准为α=0.05。结果共检索出文献9篇,其中中文文献2篇,英文文献7篇。累计病历,观察组共纳入3 327名脑性瘫痪儿童,共852名进行了剖宫产,对照组纳入1 700 535名儿童,共126 323名进行了剖宫产。其分析结果如下:总的剖宫产与脑性瘫痪儿童关系(OR=1.61;95%CI:0.93~2.79;I2=95%);足月的剖宫产与脑性瘫痪儿童的关系(OR=2.04;95%CI:1.81~2.29;I2=23%);早产的剖宫产与脑性瘫痪儿童的关系(OR=0.84;95%CI:0.63~1.13;I2=94%);急诊的剖宫产与脑性瘫痪儿童的关系(OR=9.77;95%CI:7.37~12.96;I~2=95%)。结论总体而言,剖宫产并不能减低脑性瘫痪的发生率,但在急诊剖宫产中,需要一步研究证明到底在那些情况下更容易发生脑性瘫痪。
Objective To analyze the relationship between cesarean section and the incidence of cerebral palsy in order to reduce the morbidity and disability of cerebral palsy. Methods The key words and keywords (etiology / risk factors / cesarean section) and other keywords in the database including Chinese Journal Full-text Database (CNKI), Wanfang Database, China VIP Library, PubMed database, MEDLINE database, OVID database, Cochrane Library evidence-based medical evaluation database retrieval, retrieval time for the January 1, 1990 - April 1, 2016. Meta-analysis was performed on eligible data using Review Manager 5.2 software for the included literature with a test level of α = 0.05. Results A total of 9 articles were retrieved, of which 2 were in Chinese and 7 were in English. Cumulative medical records included 3 327 cerebral palsy children in the observation group, 852 cesarean sections in the observation group, and 1 700 535 children in the control group. A total of 126 323 caesarean sections were performed. The results of the analysis were as follows: Relationship between total cesarean section and children with cerebral palsy (OR = 1.61; 95% CI: 0.93-2.79; I2 = 95%); (OR = 0.84; 95% CI: 0.63 to 1.13; I2 = 94%); and the incidence of emergency cesarean section in children with preterm birth Relationship between cesarean section and cerebral palsy children (OR = 9.77; 95% CI: 7.37-12.96; I ~ 2 = 95%). Conclusion Overall, cesarean delivery does not reduce the incidence of cerebral palsy, but in emergency cesarean sections, further studies are needed to prove that cerebral palsy is more likely to occur in those situations.