中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2015年
4期
308-311
,共4页
许静涌%朱明炜%江华%韦军民
許靜湧%硃明煒%江華%韋軍民
허정용%주명위%강화%위군민
止血,手术%Meta分析%注射用尖吻蝮蛇血凝酶%凝血功能
止血,手術%Meta分析%註射用尖吻蝮蛇血凝酶%凝血功能
지혈,수술%Meta분석%주사용첨문복사혈응매%응혈공능
Hemostasis,surgical%Meta-analysis%Hemocoagulase Agkistrodon%Coagulation
目的 系统评价注射用尖吻蝮蛇血凝酶在外科应用的安全性和有效性.方法 计算机检索中文数据库中关于注射用尖吻蝮蛇血凝酶在外科手术应用的随机对照研究(RCT),检索时间自建库至2014年5月,并追溯纳入文献的参考文献.由2位研究者按照纳入标准筛选文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5.1.0软件进行Meta分析.结果 初筛文献2 358篇,最终纳入12个RCT,共1 031例患者.Meta分析结果显示:注射用尖吻蝮蛇血凝酶与安慰剂(对照组)相比,切口平均止血时间缩短[OR=-40.29,95％ CI(-71.13,-9.44),P=0.01],切口出血量[OR=-1.38,95％CI(-1.90,-0.87),P＜0.00001]和切口单位面积出血量[OR=-0.05,95％ CI(-0.06,-0.03),P＜0.00001]减少,术中出血量和术后24h引流量[OR=-18.52,95％ CI(-25.50,-11.53),P＜0.00001]均减少.各研究中2组凝血功能、肝肾功能指标变化及不良事件均差异无统计学意义.结论 注射用尖吻蝮蛇血凝酶可以明显缩短手术切口平均止血时间,减少切口出血量、术中出血量和术后24h引流量,并不影响凝血及肝肾功能,未增加不良事件发生率.
目的 繫統評價註射用尖吻蝮蛇血凝酶在外科應用的安全性和有效性.方法 計算機檢索中文數據庫中關于註射用尖吻蝮蛇血凝酶在外科手術應用的隨機對照研究(RCT),檢索時間自建庫至2014年5月,併追溯納入文獻的參攷文獻.由2位研究者按照納入標準篩選文獻、提取資料和評價納入研究的方法學質量後,採用RevMan 5.1.0軟件進行Meta分析.結果 初篩文獻2 358篇,最終納入12箇RCT,共1 031例患者.Meta分析結果顯示:註射用尖吻蝮蛇血凝酶與安慰劑(對照組)相比,切口平均止血時間縮短[OR=-40.29,95％ CI(-71.13,-9.44),P=0.01],切口齣血量[OR=-1.38,95％CI(-1.90,-0.87),P＜0.00001]和切口單位麵積齣血量[OR=-0.05,95％ CI(-0.06,-0.03),P＜0.00001]減少,術中齣血量和術後24h引流量[OR=-18.52,95％ CI(-25.50,-11.53),P＜0.00001]均減少.各研究中2組凝血功能、肝腎功能指標變化及不良事件均差異無統計學意義.結論 註射用尖吻蝮蛇血凝酶可以明顯縮短手術切口平均止血時間,減少切口齣血量、術中齣血量和術後24h引流量,併不影響凝血及肝腎功能,未增加不良事件髮生率.
목적 계통평개주사용첨문복사혈응매재외과응용적안전성화유효성.방법 계산궤검색중문수거고중관우주사용첨문복사혈응매재외과수술응용적수궤대조연구(RCT),검색시간자건고지2014년5월,병추소납입문헌적삼고문헌.유2위연구자안조납입표준사선문헌、제취자료화평개납입연구적방법학질량후,채용RevMan 5.1.0연건진행Meta분석.결과 초사문헌2 358편,최종납입12개RCT,공1 031례환자.Meta분석결과현시:주사용첨문복사혈응매여안위제(대조조)상비,절구평균지혈시간축단[OR=-40.29,95％ CI(-71.13,-9.44),P=0.01],절구출혈량[OR=-1.38,95％CI(-1.90,-0.87),P＜0.00001]화절구단위면적출혈량[OR=-0.05,95％ CI(-0.06,-0.03),P＜0.00001]감소,술중출혈량화술후24h인류량[OR=-18.52,95％ CI(-25.50,-11.53),P＜0.00001]균감소.각연구중2조응혈공능、간신공능지표변화급불량사건균차이무통계학의의.결론 주사용첨문복사혈응매가이명현축단수술절구평균지혈시간,감소절구출혈량、술중출혈량화술후24h인류량,병불영향응혈급간신공능,미증가불량사건발생솔.
Objective To systematically evaluate the efficacy and safety of injected hemocoagulase Agkistrodon for intraoperative bleeding.Methods We electronically searched several Chinese database till May 2014 to identify randomized controlled trials (RCTs) about injected hemocoagulase Agkistrodon for operative hemorrhage.The methodological quality of included RCTs was assessed,and the data were extracted by two reviewers independently according to the Cochrane Handbook.The homogeneous RCTs were pooled using RevMan software (Version 5.1.0).Results 2 358 articles were searched initially,and 12 RCTs involving 1 031 patients met the inclusion criteria.The results of Meta-analyses showed that:in the study groups,the average haemostatic time of the wound is shorter [OR =-40.29,95％ CI(-71.13,-9.44),P =0.01],the hemorrhagic volume of the wound [OR =-1.38,95％ CI(-1.90,-0.87),P ＜ 0.000 01],hemorrhagic volume per unit area of the wound [OR =-0.05,95％ CI(-0.06,-0.03),P ＜ 0.00001],introperative hemorrhagic volume and drainage volume on POD1 [OR =-18.52,95％ CI (-25.50,-11.53),P ＜ 0.000 01] are lower than the placebo groups.In all studies,no difference was found in the variation of hemostatic function,liver and renal function and drug-induced adverse events.Conclusions The injection of hemocoagulase Agkistrodon can significantly reduce the average haemostatic time of the wound,the hemorrhagic volume of the wound,overall introperative hemorrhagic volume and drainage volume on POD1,and does not affect the hemostatic function,liver and renal function and not increase the incidence of adverse effects or postoperative complications.
