目的:当前的荟萃分析旨在通过巩固现有数据来研究HyoscineN-丁基溴(HBB)直肠对分娩时间和宫颈扩张率的影响。
方法:通过PubMed界面搜索MEDLINE,Scopus,ScienceDirect,并对2023年6月26日之前发表的有关HBB直肠对分娩时间影响的原始文章进行了Cochrane中央对照试验注册(CENTRAL)。搜索词基于MESH,没有时间和语言限制。其中包括:Hyoscine,东莨菪碱,HBB,Buscopan,Buscolesin,Buscapine,直肠,栓剂,分娩,delivery,活动阶段,第二阶段,宫颈扩张,劳动,劳动,和劳动时间。所有分析均使用综合Meta分析V3软件(CMA软件)。
结果:系统评价包括5项随机对照试验和1项非随机研究,涉及1310名女性。由于干预措施的异质性以及缺乏均值和标准差结果,两项研究被排除在荟萃分析之外。结果确定,HBB直肠给药显着降低了活跃期的持续时间(合并平均差-193.893;95%置信区间-229.173,-158.613;P<0.001;I2平方=90.097%)和第二产程(合并平均差-2.911;95%置信区间-5.486,-0.336;P=0.027;I2平方=90.097%)。此外,产程活跃期宫颈扩张率为0.981cm/h,高于对照组(I2=0.0%,P<0.001)。
结论:这项荟萃分析发现,HBB直肠给药缩短了活产期和第二阶段,增加了宫颈扩张率;因此,它可以作为低风险孕妇在分娩期间的一种具有成本效益的干预措施。虽然,我们的研究结果还表明,需要更有力的临床试验来产生证据,并确认在临产期间使用HBB作为临床实践指南.
OBJECTIVE: The current meta-analysis was designed to investigate the impact of Hyoscine N-butyl bromide (HBB) rectal on labour duration and the rate of cervical dilatation by consolidating the available data.
METHODS: The search of Medline through the PubMed interface, Scopus, ScienceDirect, and the Cochrane Central Register of Controlled Trials (CENTRAL) was performed for original articles concerning the effects of HBB rectal on the duration of labour published prior to 26 June 2023. Search terms were based on Medical Subject Headings without time and language restrictions. They included: Hyoscine, Scopolamine, HBB, Buscopan, Buscolysin, Buscapine, rectal, suppository, childbirth, delivery, active phase, second stage, cervical dilatation, labour, labour, and duration of labour. The Comprehensive Meta-Analysis V3 software was used for all analyses.
RESULTS: Five randomized control trials and 1 non-randomized study involving 1310 women were included in the systematic review. Two studies were excluded from the meta-analysis because of heterogeneous interventions and a lack of mean and SD results. The results determined that HBB rectal administration significantly decreased the duration of the active phase (pooled mean difference -193.893; 95% CI -229.173 to -158.613, P < 0.001; I2 squares = 90.097%) and second stage of labour (pooled mean difference -2.911; 95% CI -5.486 to -0.336, P = 0.027; I2 squares = 90.097%). Also, the cervical dilatation rate in the active phase of labour was 0.981 cm/h higher than in the control group (I2 = 0.0%; P < 0.001).
CONCLUSIONS: This meta-analysis found that HBB rectal administration shortened the active labour phase and second stage and increased the rate of cervix dilatation; consequently, it can be used as a cost-effective intervention for low-risk pregnant women during labour. However, our findings also suggest that more robust clinical trials are required to generate evidence and confirm the use of HBB during labour for clinical practice guidelines.