CAJ | 학술논문

目的：：系统评价在下颌后牙不可逆牙髓炎治疗中,2%利多卡因行下牙槽神经阻滞联合4%阿替卡因局部浸润和仅用2%利多卡因的局部麻醉效果差异。方法：计算机检索 Cochrane 图书馆、Pubmed、Embase、OVID、CBM、维普、万方、中国知网,同时检索相关专业杂志,会议记录,以及相关文献的参考文献,纳入相关利多卡因和阿替卡因在不可逆牙髓炎中比较的所有随机对照试验,时间截止至2013年12月31日。采用Cochrane手册中提供偏倚风险评价方法对文献进行方法学质量评价。使用 GRADE 系统评估证据质量等级。结果：共纳入4个随机对照试验,Meta分析结果显示,利多卡因联合阿替卡因组的麻醉成功率优于仅使用利多卡因组(RR=1.51,95%CI：1.23,1.87,P=0.0001),其中亚组分析利多卡因下牙槽神经阻滞联合阿替卡因局部浸润的麻醉效果也优于仅用利多卡因下牙槽神经阻滞[(RR=1.69,95%CI：1.09,2.62,P=0.02)或利多卡因下牙槽神经阻滞联合利多卡因局部浸润组(RR=1.44,95%CI：1.14,1.82,P=0.002)。GRADE 系统评价显示证据水平均为极低级。结论：在下颌后牙不可逆牙髓炎中,当前支持利多卡因联合阿替卡因的麻醉效果优于仅使用利多卡因的证据等级极低,且缺乏中国地区的相关研究,未来需更多高质量随机对照试验以进一步论证。
목적：：계통평개재하합후아불가역아수염치료중,2%리다잡인행하아조신경조체연합4%아체잡인국부침윤화부용2%리다잡인적국부마취효과차이。방법：계산궤검색 Cochrane 도서관、Pubmed、Embase、OVID、CBM、유보、만방、중국지망,동시검색상관전업잡지,회의기록,이급상관문헌적삼고문헌,납입상관리다잡인화아체잡인재불가역아수염중비교적소유수궤대조시험,시간절지지2013년12월31일。채용Cochrane수책중제공편의풍험평개방법대문헌진행방법학질량평개。사용 GRADE 계통평고증거질량등급。결과：공납입4개수궤대조시험,Meta분석결과현시,리다잡인연합아체잡인조적마취성공솔우우부사용리다잡인조(RR=1.51,95%CI：1.23,1.87,P=0.0001),기중아조분석리다잡인하아조신경조체연합아체잡인국부침윤적마취효과야우우부용리다잡인하아조신경조체[(RR=1.69,95%CI：1.09,2.62,P=0.02)혹리다잡인하아조신경조체연합리다잡인국부침윤조(RR=1.44,95%CI：1.14,1.82,P=0.002)。GRADE 계통평개현시증거수평균위겁저급。결론：재하합후아불가역아수염중,당전지지리다잡인연합아체잡인적마취효과우우부사용리다잡인적증거등급겁저,차결핍중국지구적상관연구,미래수경다고질량수궤대조시험이진일보론증。
Objective:To systematic evaluate the anesthesia efficacy of supply 2% ariticaine infiltration for 4%lidocaine IANB in patients with irreversible pulpitis in mandibular posterior teeth.Methods:Searched databases up to December 31 2013 such as:Cochrane Central Register Trials;Pubmed;EMbase;OVID;CBM;VIP;Wan Fang;CNKI,as well as retrieved special j ournals;conference proceedings and the references of those studies.Collected all of random control trials (RCT)about comparing anesthesia efficacy of articaine and lidocaine in patients with irre-versible pulpits.Studies should provided Related Risk (RR).Performed meta-analysis by using Review Manager 5 . 1 ,employed GRADE profiler 3 .6 to evaluate the evidence’quality afterwards.Results:Within 4 RCT,according to Meta-analysis,supply 2%ariticaine infiltration for 4%lidocaine IANB have a probability of achieving successful an-esthesia superior to that of solo 2% lidocaine local anesthesia in patients with irreversible pulpitis in mandibular pos-terior teeth(RR=1.51,95%CI:1.23~1.87,P=0.0001).There into,the subgroup analysis show that supply 4%ariticaine infiltration for 2% lidocaine IANB not only have a superiority in success of anesthesia than that of solo 2%lidocaine IANB in patients with irreversible pulpitis in mandibular posterior teeth(RR=1.69,95%CI:1.09~2.62, P=0.02),but also the same to 2% lidocaine IANB supply with 2% lidocaine infiltrationRR=1.44,95%CI:1.14~1.82,P=0.002).All the evidence are at level of very low when based on GRADE system.Conclusion:The current evidence supporting using supply 4% ariticaine infiltration for 2% lidocaine IANB vs.solo 2% lidocaine local anes-thesia in patients with irreversible pulpitis in mandibular posterior teeth are very low,particularly considering the lack of the related research in China,further high quality RCT are in need in the future.