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| 1 | 新生儿复苏培训降低新生儿死亡率的效能分析:文献综述,meta分析与Delphi法的应用显示文摘[背景]全球每年13600万新生儿中,约1000万需要外界的帮助才能建立自主呼吸,每年有约814000例新生儿死亡是由分娩相关足月儿死亡(以往定义为'出生窒息')所导致的。目前尚缺乏关于新生儿复苏培训降低新生儿死亡率效能的系统性评价。[目的]对在医院和社区层面开展的快速评估及初步刺激、基本的复苏措施这两种新生儿复苏培训干预方法在降低足月新生儿分娩相关死亡率('出生窒息')、早产相关并发症死亡率这两个生命指标方面的效能进行评价。[方法]采用系统综述的方法,检索并筛选符合标准的新生儿复苏培训研究文献。采用GRADE方法对文献的质量进行评价。对符合要求的文件进行Meta分析。对数据质量较低的文献采用专家咨询法估计效能大小。[结果]通过文献检索筛选了24篇新生儿复苏培训干预研究(20篇观察性研究,2篇半试验研究,2篇随机对照研究)。对其中3篇文献进行Meta分析结果显示,以医院为基础的新生儿复苏培训可使分娩相关足月儿死亡降低30%(RR=0.70,95%CI0.59~0.84);文献中涉及早产儿死亡率效能的数据质量不高,因此采用专家咨询法进行估计。以社区为基础的新生儿复苏培训干预研究具有较高的异质性,复苏培训通常是一系列培训包的一部分,且对早产儿和足月儿的定义标准不一致。专家咨询法估计结果显示,新生儿快速评估和初步刺激可使分娩相关新生儿死亡、早产儿死亡均降低10%;以医院为基础的培训可使早产儿死亡进一步降低10%,以社区为基础的培训可使分娩相关足月儿死亡率进一步降低20%,早产儿死亡率进一步降低5%。[结论]新生儿复苏培训在医院层面可以使足月新生儿分娩相关死亡率降低30%,然而中低收入水平的国家培训覆盖率仍较低。专家咨询法估计新生儿复苏培训在社区层面降低足月儿及早产儿死亡率的效能较小。需要对新生儿复苏培训的效果、成本、实施策略等进行更深入的研究与评价。 | Anne CC Lee Simon Cousens Stephen N Wall 徐韬 | 2012 | 中国妇幼卫生杂志2012，3，2： | 11 |
| 2 | Global, regional, and national causes of child mortality in 2008: a systematic analysis显示文摘 | Robert E Black Simon Cousens Hope L Johnson Joy E Lawn Igor Rudan Diego G Bassani Prabhat Jha Harry Campbell Christa Fischer Walker Richard Cibulskis Thomas Eisele Li Liu Colin Mathers | 2010 | The Lancet2010，，9730： | 3 |
| 3 | Global, regional, and national causes of child mortality in 2008: a systematic analysis显示文摘 | Robert E Black Simon Cousens Hope L Johnson Joy E Lawn Igor Rudan Diego G Bassani Prabhat Jha Harry Campbell Christa Fischer Walker Richard Cibulskis Thomas Eisele Li Liu Colin Mathers | 2010 | The Lancet . 2010 (9730)2010，，： | 2 |
| 4 | Global, regional, and national causes of child mortality in 2008 : A systematic analysis 显示文摘 | Black RE Cousens S Johnson HL | 2010 | Lancet2010，375，9730： | 1 |
| 5 | Clobal, regional, and national causes of child mortality in 2008 :A systematic analysis 显示文摘 | Black R E Cousens S Johnson H L | 2010 | Lancet2010，375，9730： | 1 |
| 6 | Global, regional, and nation- al causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000显示文摘 | Liu L Johnson H L Cousens S | 2012 | Lancet2012，379，9832： | 1 |
| 7 | Global, regional, and national causes of child mortality: an updated systematic analysis for2010 with time trend since 2000 显示文摘 | Liu L Johnson HL Cousens S | 2012 | Lancet2012，379，： | 1 |
| 8 | Global, regional, and national causes of child mortality in 2008: a systematic analysis显示文摘 | Black RE Cousens S Johnson HL | 2010 | Lancet2010，375，9730： | 1 |
| 9 | Global,regional,and national causes of child mortality:an updated systematic analysis for 2010 with time trends since 2000显示文摘 | Liu L Johnson HL Cousens S | 2012 | Lancet2012，379，9832： | 1 |
| 10 | Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality 显示文摘 | Blencowe H Cousens S Kamb M | 2011 | BMC Public Health2011，113，： | 1 |
| 11 | Aspects of the design and interpretation of competition (interference) experiments显示文摘 | Cousens R | 1991 | Weed Technology1991，5，： | 1 |
| 12 | Global, regional, andnational causes of child mortality in 2008 : a systematic analysis显示文摘 | Black RE Cousens S Johnson HL | 2010 | Lancet2010，375，9730： | 1 |
| 13 | Global, regional, and National causes of child mortality in 2008: a systematic analysis显示文摘 | Black RE Cousens S Johnson HL | 2010 | Lancet2010，375，9730： | 1 |
| 14 | Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000 显示文摘 | Liu L Johnson HL Cousens S | 2012 | Lancet2012，379，9832： | 1 |
| 15 | Global,regional,and national causes of child mortality:an updated systematic analysis for2010with time trends since 2000显示文摘 | Liu L Johnson HL Cousens S | 2012 | Lancet2012，379，9832： | 1 |
| 16 | Jaagsiekte retrovirus establishes a disseminated infection of the lymphoid tissues of sheep affected by pulmonary adenomatosis 显示文摘 | PALMARINI M HOLIJAND M J COUSENS C | 1996 | J Gen Virol1996，77，12： | 1 |
| 17 | Global,regional,and national causes of child mortality:an updated systematic analysis for 2010 with time trends since 2000显示文摘 | Liu L Johnson H L Cousens S | 2012 | Lancet2012，379，9832： | 1 |
| 18 | The potential for selecting wheat varieties strongly competitive against weeds显示文摘 | Lemerle D Verbeek B Cousens R D | 1996 | Weed Reserch1996，36，6： | 1 |
| 19 | Small scale spatial structure within patterns of seed dispersal显示文摘 | Cousens R D Wiegand T | 2008 | Oecologia2008，158，3： | 1 |
| 20 | Global,regional,and national causes of child mortalityin 2008:a systematic analysis显示文摘 | Black RE Cousens S Johnson HL lawn JE Rudan I BassaniDG | 2010 | Lancet2010，375，9730： | 1 |
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