本文選題：地佐辛 + 芬太尼　； 參考：《上海醫(yī)學(xué)》2015年12期

【摘要】：目的采用Meta分析方法評價地佐辛與芬太尼用于無痛人工流產(chǎn)手術(shù)的有效性和安全性。方法應(yīng)用計算機檢索PubMed、EMbase、Cochrane Library、維普、中國知網(wǎng)和萬方數(shù)據(jù)庫自從建庫至2014年7月間發(fā)表的關(guān)于地佐辛、芬太尼用于無痛人工流產(chǎn)手術(shù)隨機對照試驗的文章,對符合納入標(biāo)準(zhǔn)的研究進(jìn)行資料提取和文獻(xiàn)質(zhì)量評價,應(yīng)用RevMan 5.3統(tǒng)計學(xué)軟件進(jìn)行Meta分析。結(jié)果共納入12篇中文文獻(xiàn),研究對象980例,Meta分析結(jié)果如下。1安全性:地佐辛組與芬太尼組間術(shù)后蘇醒時間[標(biāo)準(zhǔn)化均數(shù)差值(SMD)=-0.26,95%CI為-0.39~-0.13]、術(shù)中脈搏血氧飽和度下降幅度(SMD=1.41,95%CI為0.75~2.06)、呼吸抑制發(fā)生例數(shù)[相對危險度(RR)=0.20,95%CI為0.12~0.34]的差異均有統(tǒng)計學(xué)意義(P值均0.01)。2有效性:地佐辛組與芬太尼組間術(shù)中發(fā)生體動的例數(shù)(RR=0.97,95%CI為0.66~1.44)、術(shù)后下腹部疼痛視覺模擬評分(SMD=-1.46,95%CI為-2.97~0.05)、出現(xiàn)宮縮痛的例數(shù)(RR=0.77,95%CI為0.43~1.39)、丙泊酚總用量(SMD=0.08,95%CI為-0.39~0.55)的差異均無統(tǒng)計學(xué)(P值均0.05)。3不良反應(yīng):地佐辛組與芬太尼組間術(shù)后惡心嘔吐患者例數(shù)的差異有統(tǒng)計學(xué)意義(RR=0.33,95%CI為0.19~0.56,P0.01)。結(jié)論依據(jù)現(xiàn)有文獻(xiàn)證據(jù),地佐辛用于無痛人工流產(chǎn)手術(shù)的鎮(zhèn)痛效果與芬太尼相似,對呼吸系統(tǒng)的抑制作用較芬太尼小,不良反應(yīng)發(fā)生率低,是有效可靠的鎮(zhèn)痛藥物。鑒于納入的研究較少、樣本量小且質(zhì)量不高,故仍需開展大樣本、多中心、高質(zhì)量的隨機對照試驗以進(jìn)一步論證。
[Abstract]:Objective to evaluate the efficacy and safety of dizosin and fentanyl in painless induced abortion by Meta analysis. Methods A computer-based search was carried out on PubMedus EMbase Cochrane Library, Weip, ChinaNet and Wanfang database on the use of dizosin and fentanyl in randomized controlled trials of painless induced abortion from the establishment of the database to July 2014. Data extraction and literature quality evaluation were carried out for the studies that met the inclusion criteria, and Meta analysis was carried out with RevMan 5.3 statistical software. Results 12 articles of Chinese literature were included. The results of meta-analysis of 980 patients were as follows: the postoperative recovery time between dizosin group and fentanyl group [standardized mean difference (SMD-0.2695 CI = -0.39 ~ 0.13], the decrease of pulse oxygen saturation during operation and the CI of SMD-1.41 + 95% CI were 0.752.06, and the number of cases of respiratory depression [ The relative risk was 0.2095 CI (0.120.34). There were significant differences in P value (P = 0.01) and validity (P = 0.01). The number of cases of intraoperative body movement between the dizosin group and fentanyl group was 0.660.67 / 95 CI = 0.661.44. The visual analogue score of postoperative lower abdominal pain (SMD-1.469595 CI = -2.97 / 5) was 0.05, and the incidence of uterine contractions was found in the patients with uterine contractions in Dizosin group and fentanyl group. There was no significant difference in the total dose of propofol and SMD-0.0895 CI (-0.39 鹵0.55) between the two groups (P = 0.05 or 0.05). There was significant difference in the number of patients with postoperative nausea and vomiting between the dizoxin group and fentanyl group. Conclusion according to the available literature evidence, the analgesic effect of dizosin in painless induced abortion is similar to that of fentanyl, the inhibitory effect on respiratory system is less than that of fentanyl, and the incidence of adverse reactions is low. It is an effective and reliable analgesic drug. In view of the small number of samples and low quality, large sample, multi-center, high quality randomized controlled trials are needed for further demonstration.
【作者單位】： 上海市普陀區(qū)利群醫(yī)院麻醉科;
【分類號】：R169.42

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本文編號：1905258