经椎管内镇痛行外倒转胎位术的有效性系统评价_《中国循证医学杂志》

作者：

1. 四川大学华西第二医院麻醉科（成都 610041）；2. 四川大学华西口腔医院麻醉科（成都 610041）;

关键词：

椎管内镇痛外倒转胎位术有效性系统评价随机对照试验

DOI：

10.7507/1672-2531.20100406

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价应用椎管内镇痛行臀先露外倒转胎位术的有效性。
方法　计算机检索CochraneLibrary（2009 年第4 期）、PubMed（1980 ～ 2009）、Ovid MEDLINE（1950 ～ 2009）、Ovid 循证医学数据库（1991 ～ 2009）、EMbase（1980 ～ 2009）、CBM（1978 ～ 2009）和CNKI（1979 ～ 2009），按纳入和排除标准筛选椎管内镇痛在外倒转胎位术中应用的随机对照试验，提取资料及评价文献质量后，采用RevMan 5.0.13 软件对数据进行Meta 分析。
结果　纳入7 个研究，共620 例产妇，其中5 个研究质量较高，1 个较低，1 个不清楚。Meta 分析结果显示，应用椎管内镇痛后臀先露胎头的外倒转成功率高于对照组，其差异有统计学意义［RR=1.53，95%CI（1.24，1.88）］。
结论　现有证据显示，椎管内镇痛较静脉给药全身镇痛或无任何镇痛措施，能明显提高臀先露外倒转胎位术的成功率。

引用本文： 柳慧,林雪梅,周俊,马玉珊. 经椎管内镇痛行外倒转胎位术的有效性系统评价. 中国循证医学杂志, 2010, 10(3): 339-345. doi: 10.7507/1672-2531.20100406 复制

1.	Hannah ME, Hannah WJ, Hewson SA, et al. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet, 2000, 356(9239): 1375-1383.
2.	Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term. The Cochrane Database of Systematic Reviews 2000, Issue 2.
3.	Collaris RJ, Oei SG. External cephalic version: a safe procedure? A systematic review of version-related risks. Acta Obstet Gynecol Scand, 2004, 83(6): 511-518.
4.	ACOG Committee on Obstetric Practice. ACOG Committee Opinion No.340. Mode of term singleton breech delivery. Obstet Gynecol, 2006, 108(1): 235-237.
5.	Royal College of Obstetricians and Gynaecologists (RCOG). External cephalic version and reducing the incidence of breech presentation. London (UK): Royal College of Obstetricians and Gynaecologists; 2008.
6.	刘迈兰, 兰蕾, 梁繁荣, 等. 针灸治疗臀先露的系统评价. 中国循证医学杂志, 2009, 9(8): 840-843.
7.	Macarthur AJ, Gagnon S, Tureanu LM, et al. Anesthesia facilitation of external cephalic version: A meta-analysis. Am J Obstet and Gynecol, 2004, 191(4): 1219-1224.
8.	Mancuso KM, Yancey MK, Murphy JA, et al. Epidural analgesia for cephalic version: a randomized trial. Obstet Gynecol, 2000, 95(5): 648-651.
9.	Schorr SJ, Speights SE, Ross EL, et al. A randomized trial of epidural anesthesia to improve external cephalic version success. Am J Obstet Gynecol, 1997, 177 (5): 1133-1137.
10.	Dugoff L, Stamm CA, Jones OW, et al. The effect of spinal anesthesia on the success rate of external cephalic version: a randomized trial. Obstet Gynecol, 1999, 93 (3): 345-349.
11.	Delisle MF, Kamani AA, Douglas MJ, et al. Antepartum external cephalic version under spinal anesthesia: A randomized controlled study [abstract]. Am J Obstet Gynecol, 2001, 185(6): S115-S115.
12.	Higgins JPT, Green S, editors. Assessing risk of bias in included studies: Cochrane Handbook for Systematic Reviews of Interventions 5.0.1 [updated September 2008], The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
13.	Birnbach DJ, Matut J, Stein DJ, et al. The Effect of Intrathecal Analgesia on the Success of External Cephalic Version. Anesth Analg, 2001, 93(2): 410-413.
14.	Weiniger CF, Ginosar Y, Elchalal U, et al. External Cephalic Version for Breech Presentation With or Without Spinal Analgesia in Nulliparous Women at Term A Randomized Controlled Trial. Obstet & Gynecol, 2007, 6(110): 1343-1350.
15.	Sullivan JT, Grobman WA, Bauchat JR, et al. A randomized controlled trial of the effect of combined spinal-epidural analgesia on the success of external cephalic version for breech presentation. Inter J Obstet Anesth, 2009, 18(4): 328-334.
16.	Hofmeyr GJ, Gyte GML. Interventions to help external cephalic version for breech presentation at term (Review). The Cochrane Database of Systematic Reviews 2009, Issue 4.
17.	吴泰相, 刘关键. 隐蔽分组 (分配隐藏) 和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
18.	Weiniger CF, Ginosar Y, Elchalal U, et al. External cephalic version at term in multiparous women with or without spinal analgesia: randomized controlled trial[Abstract]. Am J Obstet & Gynecol, 2008,.
19.	Sullivan JT, Scavone BM, Grouper S, et al. A randomized controlled trial of the impact of combined spinal-epidural analgesia on the success of external cephalic version for breech presentation[Abstract]. Anesthesiology, 2006, 104(4): B10-B10.
20.	(6): S34-S34.

1. Hannah ME, Hannah WJ, Hewson SA, et al. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet, 2000, 356(9239): 1375-1383.
2. Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term. The Cochrane Database of Systematic Reviews 2000, Issue 2.
3. Collaris RJ, Oei SG. External cephalic version: a safe procedure? A systematic review of version-related risks. Acta Obstet Gynecol Scand, 2004, 83(6): 511-518.
4. ACOG Committee on Obstetric Practice. ACOG Committee Opinion No.340. Mode of term singleton breech delivery. Obstet Gynecol, 2006, 108(1): 235-237.
5. Royal College of Obstetricians and Gynaecologists (RCOG). External cephalic version and reducing the incidence of breech presentation. London (UK): Royal College of Obstetricians and Gynaecologists; 2008.
6. 刘迈兰, 兰蕾, 梁繁荣, 等. 针灸治疗臀先露的系统评价. 中国循证医学杂志, 2009, 9(8): 840-843.
7. Macarthur AJ, Gagnon S, Tureanu LM, et al. Anesthesia facilitation of external cephalic version: A meta-analysis. Am J Obstet and Gynecol, 2004, 191(4): 1219-1224.
8. Mancuso KM, Yancey MK, Murphy JA, et al. Epidural analgesia for cephalic version: a randomized trial. Obstet Gynecol, 2000, 95(5): 648-651.
9. Schorr SJ, Speights SE, Ross EL, et al. A randomized trial of epidural anesthesia to improve external cephalic version success. Am J Obstet Gynecol, 1997, 177 (5): 1133-1137.
10. Dugoff L, Stamm CA, Jones OW, et al. The effect of spinal anesthesia on the success rate of external cephalic version: a randomized trial. Obstet Gynecol, 1999, 93 (3): 345-349.
11. Delisle MF, Kamani AA, Douglas MJ, et al. Antepartum external cephalic version under spinal anesthesia: A randomized controlled study [abstract]. Am J Obstet Gynecol, 2001, 185(6): S115-S115.
12. Higgins JPT, Green S, editors. Assessing risk of bias in included studies: Cochrane Handbook for Systematic Reviews of Interventions 5.0.1 [updated September 2008], The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
13. Birnbach DJ, Matut J, Stein DJ, et al. The Effect of Intrathecal Analgesia on the Success of External Cephalic Version. Anesth Analg, 2001, 93(2): 410-413.
14. Weiniger CF, Ginosar Y, Elchalal U, et al. External Cephalic Version for Breech Presentation With or Without Spinal Analgesia in Nulliparous Women at Term A Randomized Controlled Trial. Obstet & Gynecol, 2007, 6(110): 1343-1350.
15. Sullivan JT, Grobman WA, Bauchat JR, et al. A randomized controlled trial of the effect of combined spinal-epidural analgesia on the success of external cephalic version for breech presentation. Inter J Obstet Anesth, 2009, 18(4): 328-334.
16. Hofmeyr GJ, Gyte GML. Interventions to help external cephalic version for breech presentation at term (Review). The Cochrane Database of Systematic Reviews 2009, Issue 4.
17. 吴泰相, 刘关键. 隐蔽分组 (分配隐藏) 和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
18. Weiniger CF, Ginosar Y, Elchalal U, et al. External cephalic version at term in multiparous women with or without spinal analgesia: randomized controlled trial[Abstract]. Am J Obstet & Gynecol, 2008,.
19. Sullivan JT, Scavone BM, Grouper S, et al. A randomized controlled trial of the impact of combined spinal-epidural analgesia on the success of external cephalic version for breech presentation[Abstract]. Anesthesiology, 2006, 104(4): B10-B10.
20. (6): S34-S34.

《中国循证医学杂志》

经椎管内镇痛行外倒转胎位术的有效性系统评价

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《中国循证医学杂志》

经椎管内镇痛行外倒转胎位术的有效性系统评价

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