【摘要】 目的 系统评价分娩计划对产妇分娩过程医疗干预和分娩结局的影响。方法 计算机检索Cochrane Library、PubMed、Embase、CINAHL、Web of Science、临床试验注册中心、中国知网(CNKI)、万方数据库、维普数据库和中国生物医学文献数据库(CBM)关于分娩计划对产妇分娩过程医疗干预以及分娩结局影响的相关随机对照试验文献，检索时限为2000年1月—2021年5月。由2名评价人员按照Cochrane系统评价员手册5.1.0标准独立进行文献筛选、资料提取和质量评价后，采用RevMan5.3软件进行Meta分析。结果 纳入6项研究的总样本量为1253例，对照组采用常规护理，试验组在对照组的基础上孕妇参与制定并实施分娩计划。Meta分析结果显示，试验组的剖宫产率、会阴侧切率低于对照组[RR=0.61, 95%CI(0.50, 0.75), P<0.01;RR=0.57, 95%CI(0.37,0.87), P<0.01]，试验组的分娩视觉模拟疼痛评分、总产程时间低于对照组[MD=-2.93, 95%CI(-3.22,-2.63),P<0.01;MD=-2.02, 95%CI(-2.38,-1.67),P <0.01]，两组的硬膜外麻醉率、新生儿窒息率比较差异无统计学意义[RR=1.03, 95%CI (0.89,1.18),P=0.72; RR=0.55, 95%CI (0.29,1.05), P=0.07]。结论 分娩计划能够降低非必要医疗干预，降低剖宫产率、会阴侧切率、产妇分娩视觉模拟疼痛评分，缩短总产程时间，对硬膜外麻醉镇痛率以及新生儿窒息率的影响不明显。国内学者应提高对分娩计划的关注度，进一步研究分娩计划的应用效果并推广使用。更多还原

【Abstract】 Objective To systematically review the ef fect of birth planning on maternal medical interventions during labor and delivery outcomes was set as the study object. Methods The Cochrane Library, PubMed、Embase, CINAHL, Web of Science, Clinical Trial Registry, CNKI, Wanfang database, VIP database and China Biomedical Literature Database(CBM) were searched by computer for relevant randomized controlled trials literature on the impact of labor planning on medical intervention in the maternal labor process and labor outcomes. The search period was from January 2000 to May 2021. Two reviewers independently conducted literature screening, data extraction and quality assessment according to the Cochrane Manual of Systematic Reviewers 5.1.0 standard, and then used RevMan 5.3 software to conduct Meta-analysis. Results The total sample size of the 6 studies was 1,253 cases. The control group received routine nursing care. On the basis of the control group, pregnant women participated in the formulation and implementation of delivery plans. Metaanalysis results showed that the cesarean section rate and episiotomy rate of the experimental group were lower than those of the control group[RR =0.61, 95%CI(0.50, 0.75), P <0.01; RR =0.57, 95%CI(0.37, 0.87), P <0.01],the visual analogue pain score of labor and the total labor time of the experimental group were lower than those of the control group[MD =-2.93, 95%CI(-3.22,-2.63), P <0.01; MD =-2.02, 95%CI(-2.38,-1.67), P <0.01], the epidural anesthesia rate, neonatal asphyxia rate of the two groups were lower than those of the control group. The diff erence in rates was not statistically signifi cant[RR=1.03, 95%CI(0.89,1.18), P=0.72; RR=0.55, 95%CI(0.29,1.05), P=0.07]. Conclusions The delivery planning can reduce unnecessary medical intervention, reduce the rate of cesarean section, episiotomy rate, visual analog pain score of parturient labor, shorten the total labor time, and had no signifi cant eff ect on the rate of epidural analgesia and neonatal asphyxia. Domestic scholars should pay more attention to the delivery plan, and further study the application eff ect of the delivery plan and promote its use.更多还原