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热疗法对初产妇疼痛强度、第一产程产程及阿氏评分的影响:一项系统评价与Meta分析

The effect of heat therapy on pain intensity, duration of labor during first stage among primiparous women and Apgar scores: A systematic review and meta-analysis.

作者信息

Goswami Sujata, Jelly Prasuna, Sharma Suresh K, Negi Rizu, Sharma Rakesh

机构信息

College of Nursing, All India Institute of Medical Sciences, Rishikesh, India.

College of Nursing, All India Institute of Medical Sciences, Jodhpur, India.

出版信息

Eur J Midwifery. 2022 Nov 28;6:66. doi: 10.18332/ejm/156487. eCollection 2022.

Abstract

INTRODUCTION

Heat therapy may help in reducing pain during labor as it blocks the receptors of pain, according to gate control theory. This systematic review and meta-analysis study aims to evaluate the effect of heat therapy (HT) systematically and critically on pain intensity, duration of labor during the first stage of labor and Apgar scores.

METHODS

We searched for randomized controlled trials published until October 2020 in PubMed/Medline, EMBASE, ClinicalKey, Ovid Discovery, and other sources. Randomized controlled trials (RCTs) comparing heat therapy with standard treatment were selected.

RESULTS

Out of 7625 screened, 10 studies met the inclusion criteria. The results of pooled data have shown that heat therapy was significantly effective in reducing pain intensity in the first stage of labor (standard mean difference, SMD= -1.31; 95% CI: -1.88 - -0.73; p<0.001). Heat therapy had significantly reduced the duration of the first stage of labor (pooled MD= -50.09; 95% CI: -89.70-10.48; p=0.01) and was also superior to the standard therapy group in terms of better Apgar scores at the 5th minute of birth of the newborn (pooled MD= -0.10; 95% CI: -0.19-0.02; p=0.02).

CONCLUSIONS

Current evidence shows that heat therapy effectively decreases labor pain intensity and shortens the duration of labor in the first stage, and it can be used as nonpharmacological management for labor pain.

摘要

引言

根据闸门控制理论,热疗法可能有助于减轻分娩时的疼痛,因为它能阻断疼痛感受器。本系统评价和荟萃分析研究旨在系统且严格地评估热疗法(HT)对疼痛强度、第一产程分娩持续时间和阿氏评分的影响。

方法

我们检索了截至2020年10月在PubMed/Medline、EMBASE、ClinicalKey、Ovid Discovery及其他来源发表的随机对照试验。选择了比较热疗法与标准治疗的随机对照试验(RCT)。

结果

在筛选的7625项研究中,有10项符合纳入标准。汇总数据结果表明,热疗法在降低第一产程疼痛强度方面显著有效(标准均差,SMD = -1.31;95%置信区间:-1.88至-0.73;p<0.001)。热疗法显著缩短了第一产程的持续时间(汇总平均差 = -50.09;95%置信区间:-89.70至-10.48;p = 0.01),并且在新生儿出生后第5分钟时,热疗法组的阿氏评分也优于标准治疗组(汇总平均差 = -0.10;95%置信区间:-0.19至-0.02;p = 0.02)。

结论

目前的证据表明,热疗法能有效降低分娩疼痛强度并缩短第一产程的持续时间,可作为分娩疼痛的非药物管理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/679e/9703937/3f67d04b4238/EJM-6-66-g001.jpg

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