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腹带对剖宫产术后女性的疗效:一项随机对照试验的荟萃分析。

The efficacy of abdominal binder in women undergoing cesarean delivery: A meta-analysis of randomized controlled trials.

作者信息

Lin Shu-Ling, Yen Chih-Feng, Hsieh Chia-Jung, Chang Wen-Pei, Wang Chia-Hui

机构信息

School of Nursing, College of Nursing, Taipei Medical University, Taipei 110301, Taiwan.

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Kwei-Shan, Tao-Yuan 333423, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 333423, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu 300044, Taiwan.

出版信息

Midwifery. 2025 Mar;142:104281. doi: 10.1016/j.midw.2024.104281. Epub 2024 Dec 31.

DOI:10.1016/j.midw.2024.104281
PMID:39793406
Abstract

BACKGROUND

Abdominal binders are a prominent non-pharmacological intervention aimed at mitigating adverse outcomes following Cesarean delivery (CD), including pain and distress.

AIM

We conducted a meta-analysis to quantitatively evaluate the effects of abdominal binders on women undergoing CD.

METHODS

A systematic search was conducted using terms such as "abdominal binder," "clinical trials," and variations of "cesarean" across multiple electronic databases, including PubMed, Google Scholar, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Chinese National Knowledge Infrastructure (CNKI), and Wan-Fang database, up to November 2024. Study quality was assessed using the Cochrane Risk of Bias Tool 2.0. Statistical analysis was performed using Review Manager 5.4 and Comprehensive Meta-Analysis 4.0. Randomized controlled trials (RCTs) evaluating the use of abdominal binders compared to no binder usage following CD were included. The outcomes analyzed were postoperative pain, symptom distress, ambulatory function, and the occurrence of adverse effects.

RESULTS

Thirteen RCTs were included. Abdominal binders demonstrated a strong safety profile with no significant differences in postoperative complications between groups. Significant pain reductions were observed at 6, 12, 24, and 48 h postoperatively (weighted mean differences [WMD]: -1.13, 95 % confidence interval [CI]: -2.15 to -0.10, p = 0.03; WMD: -1.48, 95 % CI: -2.90 to -0.06, p = 0.04;WMD: -0.95, 95 % CI: -1.49 to -0.41, p = 0.0005; and WMD: -0.70, 95 % CI: -1.17 to -0.22, p = 0.004, respectively). Pain interference with breastfeeding was significantly lower in the binder group (WMD: -1.30, 95 % CI: -2.24 to -0.36, p = 0.006). Symptom Distress Scale scores were significantly reduced at 24 and 48 h (WMD: -1.22, 95 % CI: -2.05 to -0.39, p = 0.004; WMD: -1.63, 95 % CI: -2.67 to -0.60, p = 0.002). Improved ambulatory function was also observed at 8, 12, and 24 h (WMD: 20.57, 95 % CI: 16.91 to 24.23, p < 0.00001; WMD: 11.97, 95 % CI: 7.67 to 16.27, p < 0.00001; WMD: 10.14, 95 % CI: 1.89 to 18.40, p = 0.02, respectively).

CONCLUSIONS

This study uniquely demonstrates the temporal effects of abdominal binder use, with significant pain reductions noted at 6, 12, 24, and 48 h post-CD. These results provide actionable guidance for the timing of abdominal binder application, emphasizing their importance as an early intervention to optimize postoperative recovery. As a secure, cost-effective, and non-pharmacological solution, abdominal binders are strongly recommended as part of routine postpartum care for women following CD.

摘要

背景

腹带是一种重要的非药物干预措施,旨在减轻剖宫产术后的不良后果,包括疼痛和不适。

目的

我们进行了一项荟萃分析,以定量评估腹带对剖宫产女性的影响。

方法

在多个电子数据库中进行系统检索,使用了“腹带”、“临床试验”以及“剖宫产”的变体等术语,包括PubMed、谷歌学术、Embase、Cochrane对照试验中央注册库、ClinicalTrials.gov、中国知网(CNKI)和万方数据库,检索截至2024年11月。使用Cochrane偏倚风险工具2.0评估研究质量。使用Review Manager 5.4和Comprehensive Meta-Analysis 4.0进行统计分析。纳入评估剖宫产术后使用腹带与不使用腹带效果的随机对照试验(RCT)。分析的结局指标包括术后疼痛、症状困扰、活动功能和不良反应的发生情况。

结果

纳入了13项RCT。腹带显示出良好的安全性,两组术后并发症无显著差异。术后6、12、24和48小时观察到疼痛显著减轻(加权平均差[WMD]:-1.13,95%置信区间[CI]:-2.15至-0.10,p = 0.03;WMD:-1.48,95% CI:-2.90至-0.06,p = 0.04;WMD:-0.95,95% CI:-1.49至-0.41,p = 0.0005;以及WMD:-0.70,95% CI:-1.17至-0.22,p = 0.004)。腹带组疼痛对母乳喂养的干扰显著更低(WMD:-1.30,95% CI:-2.24至-0.36,p = 0.006)。症状困扰量表评分在24和48小时显著降低(WMD:-1.22,95% CI:-2.05至-0.39,p = 0.004;WMD:-1.63,95% CI:-2.67至-0.60,p = 0.002)。在8、12和24小时也观察到活动功能改善(WMD:20.57,95% CI:16.91至24.23,p < 0.00001;WMD:11.97,95% CI:7.67至16.27,p < 0.00001;WMD:10.14,95% CI:1.89至18.40,p = 0.02)。

结论

本研究独特地展示了使用腹带的时间效应,剖宫产术后6、12、24和48小时疼痛显著减轻。这些结果为腹带应用的时机提供了可操作的指导,强调了其作为优化术后恢复的早期干预措施的重要性。作为一种安全、经济有效且非药物的解决方案,强烈推荐腹带作为剖宫产术后女性常规产后护理的一部分。

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