摘要
目的系统评价剖宫产术后慢性疼痛(CPCSP)的患病率和危险因素。方法计算机检索PubMed、EMbase、The Cochrane Library、CINAHL、PsycInfo、CBM、WanFang Data、VIP和CNKI数据库,搜集报告CPCSP患病率或危险因素的临床研究,检索时限均为建库至2021年8月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 15.1软件进行Meta分析。结果共纳入43个研究,包括12 435例剖宫产术后产妇。Meta分析结果显示:2~5个月、6~11个月、12个月及以上CPCSP患病率分别为19%[95%CI(15%,23%)]、13%[95%CI(9%,17%)]、8%[95%CI(6%,10%)]。CPCSP可能的危险因素包括术前其他部位疼痛、术后严重急性疼痛、低位腹壁横切口、非鞘内注射吗啡、术前焦虑、产后抑郁等。结论当前证据表明,CPCSP整体患病率较高。术前其他部位疼痛、术后严重急性疼痛、低位腹壁横切口、非鞘内注射吗啡、术前焦虑、产后抑郁等均可能增加CPCSP患病风险。
Objective To systematically review the prevalence and risk factors of the chronic post-cesarean section pain(CPCSP). Methods PubMed, EMbase, The Cochrane Library, CINAHL, PsycInfo, CBM, WanFang Data,VIP, and CNKI databases were electronically searched to collect studies on the prevalence and risk factors of CPCSP from inception to August 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 15.1 software. Results A total of 43 studies involving 12435 participants were included. The results of meta-analysis showed that the prevalence of CPCSP for 2 to 5 months, 6 to11 months, and at least 12 months were 19%(95%CI 15% to 23%), 13%(95%CI 9% to 17%), and 8%(95%CI 6% to 10%),respectively. The risk factors included preoperative pain present elsewhere, postoperative severe acute pain, low abdominal transverse incision, non-intrathecal administration of morphine, preoperative anxiety, postpartum depression, etc.Conclusions The current evidence shows that the overall prevalence of CPCSP is high. Preoperative pain presents elsewhere, postoperative severe acute pain, low abdominal transverse incision, non-intrathecal administration of morphine, preoperative anxiety and postpartum depression may increase the risk of CPCSP.
作者
王圆圆
刘洪园
陈颖
余晓萍
张艳
孔祥
WANG Yuanyuan;LIU Hongyuan;CHEN Ying;YU Xiaoping;ZHANG Yan;KONG Xiang(School of Nursing,Yangzhou University,Yangzhou 225100,P.R.China;Department of Nursing,Yizheng People's Hospital,Yizheng 211400,P.R.China;Medical College of Yangzhou University,Yangzhou 225100,P.R.China;Department of Obstetrics and Gynecology,Northern Jiangsu People's Hospital,Yangzhou 225100,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2021年第10期1195-1202,共8页
Chinese Journal of Evidence-based Medicine
基金
江苏省妇幼健康科研项目(编号:F201809)。
关键词
剖宫产
术后慢性疼痛
患病率
危险因素
系统评价
META分析
Cesarean section
Chronic post-surgical pain
Prevalence
Risk factor
Systematic review
Meta-analysis
