【摘要】：目的：評(píng)估糖皮質(zhì)激素對(duì)建立人工氣道后咽喉部并發(fā)癥預(yù)防作用的有效性及安全性。 方法：計(jì)算機(jī)檢索了英文數(shù)據(jù)庫(kù)：EMBASE、PubMed、ISI Web of Knowledge、The CochraneLibrary；中文數(shù)據(jù)庫(kù)：中國(guó)生物醫(yī)學(xué)數(shù)據(jù)庫(kù)、萬(wàn)方數(shù)據(jù)庫(kù)、維普數(shù)據(jù)庫(kù)、中國(guó)知網(wǎng)數(shù)據(jù)庫(kù)，同時(shí)手工檢索了相關(guān)研究的參考文獻(xiàn)。查找局部或全身使用激素與安慰劑或空白對(duì)照組相比，預(yù)防建立人工氣道后咽喉部并發(fā)癥的隨機(jī)對(duì)照試驗(yàn)。本研究的建立人工氣道后咽喉部并發(fā)癥包括咽喉痛、聲嘶、咳嗽。由兩個(gè)研究者根據(jù)納入和排除標(biāo)準(zhǔn)獨(dú)立篩選文獻(xiàn)，評(píng)估研究質(zhì)量及偏倚風(fēng)險(xiǎn)情況，并應(yīng)用RevMan5.2軟件進(jìn)行Meta分析。 結(jié)果：共納入19個(gè)隨機(jī)對(duì)照試驗(yàn)，共有2084例個(gè)病例，其中激素組1241例，對(duì)照組843例。激素可降低術(shù)后咽喉痛、聲嘶、咳嗽的發(fā)病率，術(shù)后1-3小時(shí)（hour，h）的相對(duì)危險(xiǎn)度（relativerisk，，RR）值及95%的置信區(qū)間（confidence interval，CI）分別為0.50[0.37,0.67]、0.43[0.30,0.61]、0.55[0.35,0.88]，需要防治的病例數(shù)（number needed to treat，NNT）分別為4.0、3.9、7.9；術(shù)后24h的RR值及95%CI分別為0.51[0.43,0.60]、0.58[0.48,0.70]、0.42[0.22,0.82]，NNT分別為5.5、5.6、5.6。同時(shí)糖皮質(zhì)激素也降低術(shù)后咽喉痛的程度，1-3h、24h的標(biāo)準(zhǔn)化均數(shù)差分別為-1.47[-1.85,-1.09]、-0.97[-1.40,-0.53]，在糖皮質(zhì)激素的不良反應(yīng)上，僅2個(gè)研究有描述，且未發(fā)現(xiàn)糖皮質(zhì)激素相關(guān)不良反應(yīng)，其余均未報(bào)告。 結(jié)論：使用糖皮質(zhì)激素可降低成人建立人工氣道后咽喉部并發(fā)癥的發(fā)病率，且用藥途徑可對(duì)糖皮質(zhì)激素的預(yù)防效果產(chǎn)生影響，局部用藥效果優(yōu)于全身用藥。
[Abstract]:Objective: to evaluate the efficacy and safety of glucocorticoid in the prevention of pharynx and larynx complications after the establishment of artificial airway. Methods: the English database: EMBASEE PubMedi Web of knowledge of the Cochrane Library was searched by computer; the Chinese database: China Biomedical Database, Wanfang Database, Weip Database, China knowledge Network Database, and the related references were searched by hand. A randomized controlled trial was conducted to find out whether local or systemic use of hormones was compared with placebo or blank control to prevent complications of the pharyngopharynx after the establishment of artificial airways. Complications following the establishment of an artificial airway in this study included sore throat, hoarseness, and cough. According to the inclusion and exclusion criteria, two researchers independently sifted the literature to evaluate the quality of the study and bias risk, and used Revman 5.2 software to conduct meta-analysis. Results: a total of 2084 cases were included in 19 randomized controlled trials, including 1241 cases in hormone group and 843 cases in control group. Hormone could reduce the incidence of larynx, hoarseness and cough. The relative risk (RR) and 95% confidence interval (CI) of 1-3 hours after operation were 0.50 [0.370.67] 0.43 [0.300.61] 0.55 [0.350.88], and the number of cases in need of prevention and treatment were 4.03.97.9nt; The RR value and 95 CI at 24 hours after operation were 0.51 [0.43 鹵0.60] 0.58 [0.488 0.70] 0.42 [0.22 ~ 0.82] respectively. At the same time, glucocorticoid also reduced the degree of larynx pain after operation. The standardized mean difference of 24 hours after operation was -1.47 [-1.85 ~ 1.09] -0.97 [-1.40 ~ 0.53]. Only two studies described the adverse effects of glucocorticoid, and no glucocorticoid-related adverse reactions were found, and no other adverse reactions were reported. Conclusion: the use of glucocorticoid can reduce the incidence of pharynx and larynx complications after the establishment of artificial airway in adults, and the preventive effect of glucocorticoid can be affected by the way of medication, and the effect of local administration is better than that of the whole body.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 陸輝;劉桂林;劉玲玲;葉秀清;鄭燕;;地塞米松和氟比洛芬酯聯(lián)用預(yù)防氣管導(dǎo)管拔管后咽痛的臨床觀察[J];福建醫(yī)藥雜志;2011年02期

2 程高升;吳江燕;;氟比洛芬酯配合氫化潑尼松預(yù)防氣管插管全麻術(shù)后咽喉痛[J];海峽藥學(xué);2011年11期

3 郭海明;龐志路;孫政;李佩涵;韓雪萍;;復(fù)方地塞米松預(yù)防氣管插管術(shù)后氣道并發(fā)癥的臨床研究[J];河南醫(yī)學(xué)研究;2012年01期

4 曾憲濤;包翠萍;曹世義;劉菊英;;Meta分析系列之三:隨機(jī)對(duì)照試驗(yàn)的質(zhì)量評(píng)價(jià)工具[J];中國(guó)循證心血管醫(yī)學(xué)雜志;2012年03期

5 解康杰;方軍;連燕虹;;帕瑞昔布鈉復(fù)合地塞米松預(yù)防甲狀腺癌根治手術(shù)全麻后咽喉痛[J];全科醫(yī)學(xué)臨床與教育;2012年04期

6 陳麗紅;馮鵬玖;龐芹;賈月嬌;;經(jīng)口鼻氧氣驅(qū)動(dòng)霧化在復(fù)蘇室全身麻醉氣管拔管后的應(yīng)用[J];中國(guó)當(dāng)代醫(yī)藥;2011年21期

本文編號(hào)：2136683