經椎管內鎮痛行外倒轉胎位術的有效性系統評價_《中國循證醫學雜志》

作者：

1. 四川大學華西第二醫院麻醉科（成都 610041）；2. 四川大學華西口腔醫院麻醉科（成都 610041）;

關鍵詞：

椎管內鎮痛外倒轉胎位術有效性系統評價隨機對照試驗

DOI：

10.7507/1672-2531.20100406

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目的　系統評價應用椎管內鎮痛行臀先露外倒轉胎位術的有效性。
方法　計算機檢索CochraneLibrary（2009 年第4 期）、PubMed（1980 ～ 2009）、Ovid MEDLINE（1950 ～ 2009）、Ovid 循證醫學數據庫（1991 ～ 2009）、EMbase（1980 ～ 2009）、CBM（1978 ～ 2009）和CNKI（1979 ～ 2009），按納入和排除標準篩選椎管內鎮痛在外倒轉胎位術中應用的隨機對照試驗，提取資料及評價文獻質量后，采用RevMan 5.0.13 軟件對數據進行Meta 分析。
結果　納入7 個研究，共620 例產婦，其中5 個研究質量較高，1 個較低，1 個不清楚。Meta 分析結果顯示，應用椎管內鎮痛后臀先露胎頭的外倒轉成功率高于對照組，其差異有統計學意義［RR=1.53，95%CI（1.24，1.88）］。
結論　現有證據顯示，椎管內鎮痛較靜脈給藥全身鎮痛或無任何鎮痛措施，能明顯提高臀先露外倒轉胎位術的成功率。

引用本文： 柳慧,林雪梅,周俊,馬玉珊. 經椎管內鎮痛行外倒轉胎位術的有效性系統評價. 中國循證醫學雜志, 2010, 10(3): 339-345. doi: 10.7507/1672-2531.20100406 復制

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.	劉邁蘭, 蘭蕾, 梁繁榮, 等. 針灸治療臀先露的系統評價. 中國循證醫學雜志, 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.	吳泰相, 劉關鍵. 隱蔽分組 (分配隱藏) 和盲法的概念、實施與報告. 中國循證醫學雜志, 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. 劉邁蘭, 蘭蕾, 梁繁榮, 等. 針灸治療臀先露的系統評價. 中國循證醫學雜志, 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. 吳泰相, 劉關鍵. 隱蔽分組 (分配隱藏) 和盲法的概念、實施與報告. 中國循證醫學雜志, 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.

《中國循證醫學雜志》

經椎管內鎮痛行外倒轉胎位術的有效性系統評價

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《中國循證醫學雜志》

經椎管內鎮痛行外倒轉胎位術的有效性系統評價

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