中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2013年
3期
129-136
,共8页
黄春玲%周丛乐%汤泽中%李雪迎%王红梅%侯新林%姜毅
黃春玲%週叢樂%湯澤中%李雪迎%王紅梅%侯新林%薑毅
황춘령%주총악%탕택중%리설영%왕홍매%후신림%강의
新生儿脑梗死%高危因素%系统评价%荟萃分析
新生兒腦梗死%高危因素%繫統評價%薈萃分析
신생인뇌경사%고위인소%계통평개%회췌분석
Infant,newborn%Cerebral infarction%Risk factors%Systematic review%Meta analysis
目的 利用系统评价的方法探讨导致新生儿脑梗死的危险因素. 方法 通过检索中国知网、维普、万方、PubMed、OVID、Springer、Medline、Science Direct On Site、Besco及MD Consult 等数据库,收集1997年至2011年关于新生儿脑梗死危险因素的病例对照研究文献、病例报道文献及病例总结文献,按纳入和剔除标准进行筛选.采用随机效应模型或固定效应模型,通过Review Manager 5.0软件对病例对照文献进行荟萃分析.对病例报道及病例总结文献,分析新生儿脑梗死患儿中各危险因素的构成比. 结果 共检索269篇相关文献,符合纳入标准的文献共36篇,均为英文.其中病例对照文献3篇,病例总结文献17篇,病例报道文献16篇.病例对照文献累计病例80例,对照228例.各因素合并OR值(95％ CI)分别为:胎动减少7.10(2.92～17.24)；胎心异常4.45(2.54～7.80)；胎吸2.99(1.23～7.25);出生需要复苏3.14 (1.17～8.46);破膜时间长2.40(0.62～9.29)；剖宫产2.64(1.44～4.82);子痫前期3.05 (1.44～6.43);母亲有不孕史1.25(0.18～8.67);初产1.79(0.51～6.36);催产素催产2.05 (0.99～4.25)；胎儿生长受限0.99(0.47～2.11)；羊水粪染2.08(0.94～4.58)；不良产史0.85(0.43～1.68)；臀位0.38(0.10～1.46).荟萃分析结果显示,胎动减少、胎心异常、胎吸、出生需要复苏、剖宫产、子痫前期是新生儿脑梗死的高危因素.病例总结文献17篇,共530例,其中异常分娩、胎儿窘迫、高凝状态在危险因素中所占比例较大,分别为31.70％、21.13％及20.19％.病例报道文献16篇,共25例,其中高凝状态所占比例较大,为32.00％. 结论 围产期缺氧、异常分娩、子痫前期、高凝状态可能是新生儿脑梗死的高危因素.
目的 利用繫統評價的方法探討導緻新生兒腦梗死的危險因素. 方法 通過檢索中國知網、維普、萬方、PubMed、OVID、Springer、Medline、Science Direct On Site、Besco及MD Consult 等數據庫,收集1997年至2011年關于新生兒腦梗死危險因素的病例對照研究文獻、病例報道文獻及病例總結文獻,按納入和剔除標準進行篩選.採用隨機效應模型或固定效應模型,通過Review Manager 5.0軟件對病例對照文獻進行薈萃分析.對病例報道及病例總結文獻,分析新生兒腦梗死患兒中各危險因素的構成比. 結果 共檢索269篇相關文獻,符閤納入標準的文獻共36篇,均為英文.其中病例對照文獻3篇,病例總結文獻17篇,病例報道文獻16篇.病例對照文獻纍計病例80例,對照228例.各因素閤併OR值(95％ CI)分彆為:胎動減少7.10(2.92～17.24)；胎心異常4.45(2.54～7.80)；胎吸2.99(1.23～7.25);齣生需要複囌3.14 (1.17～8.46);破膜時間長2.40(0.62～9.29)；剖宮產2.64(1.44～4.82);子癇前期3.05 (1.44～6.43);母親有不孕史1.25(0.18～8.67);初產1.79(0.51～6.36);催產素催產2.05 (0.99～4.25)；胎兒生長受限0.99(0.47～2.11)；羊水糞染2.08(0.94～4.58)；不良產史0.85(0.43～1.68)；臀位0.38(0.10～1.46).薈萃分析結果顯示,胎動減少、胎心異常、胎吸、齣生需要複囌、剖宮產、子癇前期是新生兒腦梗死的高危因素.病例總結文獻17篇,共530例,其中異常分娩、胎兒窘迫、高凝狀態在危險因素中所佔比例較大,分彆為31.70％、21.13％及20.19％.病例報道文獻16篇,共25例,其中高凝狀態所佔比例較大,為32.00％. 結論 圍產期缺氧、異常分娩、子癇前期、高凝狀態可能是新生兒腦梗死的高危因素.
목적 이용계통평개적방법탐토도치신생인뇌경사적위험인소. 방법 통과검색중국지망、유보、만방、PubMed、OVID、Springer、Medline、Science Direct On Site、Besco급MD Consult 등수거고,수집1997년지2011년관우신생인뇌경사위험인소적병례대조연구문헌、병례보도문헌급병례총결문헌,안납입화척제표준진행사선.채용수궤효응모형혹고정효응모형,통과Review Manager 5.0연건대병례대조문헌진행회췌분석.대병례보도급병례총결문헌,분석신생인뇌경사환인중각위험인소적구성비. 결과 공검색269편상관문헌,부합납입표준적문헌공36편,균위영문.기중병례대조문헌3편,병례총결문헌17편,병례보도문헌16편.병례대조문헌루계병례80례,대조228례.각인소합병OR치(95％ CI)분별위:태동감소7.10(2.92～17.24)；태심이상4.45(2.54～7.80)；태흡2.99(1.23～7.25);출생수요복소3.14 (1.17～8.46);파막시간장2.40(0.62～9.29)；부궁산2.64(1.44～4.82);자간전기3.05 (1.44～6.43);모친유불잉사1.25(0.18～8.67);초산1.79(0.51～6.36);최산소최산2.05 (0.99～4.25)；태인생장수한0.99(0.47～2.11)；양수분염2.08(0.94～4.58)；불량산사0.85(0.43～1.68)；둔위0.38(0.10～1.46).회췌분석결과현시,태동감소、태심이상、태흡、출생수요복소、부궁산、자간전기시신생인뇌경사적고위인소.병례총결문헌17편,공530례,기중이상분면、태인군박、고응상태재위험인소중소점비례교대,분별위31.70％、21.13％급20.19％.병례보도문헌16편,공25례,기중고응상태소점비례교대,위32.00％. 결론 위산기결양、이상분면、자간전기、고응상태가능시신생인뇌경사적고위인소.
Objective To explore risk factors of cerebral infarction in newborns by systematic reviews.Methods Case-control studies and case reports on risk factors of cerebral infarction in newborns from January 1997 to December 2011 were collected from database of CNKI,CQVIP,Wanfang Database,PubMed,OVID,Springer,Medline,Science Direct On Site,Besco and MD Consult.Meta analysis was performed on case-control studies with fixed or random effect model by Review Manager 5.0.Constitution ratio of risk factors of cerebral infarction in newborns in case reports was investigated.Results Two hundred and sixty-nine articles were found and among which,36 articles in English were selected for this study.Three case-control studies were found and adopted for meta analysis.Cumulative number of patients and control cases were 80 and 228,respectively.The pooled OR and 95 ％CI of selected factors were as follows:decreased fetal movement [7.10 (2.92-17.24)],abnormal fetal heart rate [4.45 (2.54-7.80)],vacuum delivery [2.99 (1.23-7.25)],resuscitation at birth [(3.14 (1.17-8.46)],premature rupture of membranes [2.40 (0.62-9.29)],cesarean section [2.64 (1.44-4.82)],preeclampsia [3.05 (1.44-6.43)],history of infertility [1.25 (0.18-8.67)],primiparous [1.79 (0.51-6.36)],oxytocin used [2.05 (0.99-4.25)],fetal growth restriction [0.99 (0.47-2.11)],meconium stained amniotic fluid [2.08 (0.94-4.58)],adverse pregnancy history [0.85 (0.43-1.68)] and breech presentation [0.38 (0.10-1.46)].Meta analysis showed that decreased fetal movement,abnormal fetal heart rate,vacuum extraction,resuscitation at birth,cesarean section and preeclampsia were risk factors of neonatal cerebral infarction.Decreased fetal movement,abnormal fetal heart rate and resuscitation at birth suggested that newborns suffered from perinatal hypoxia,vacuum extraction,cesarean section suggested abnormal delivery.It suggested that perinatal hypoxia and abnormal delivery were high risk factors of neonatal cerebral infarction.Among those factors,proportion of abnormal labor,fetal distress and hypercoagulabe state was 31.70％,21.13％ and 20.19％ respectively.Conclusions Abnormal birth,hypoxia,preeclampsia and hypercoagulation state might relate to neonatal cerebral infarction.
