国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2015年
3期
218-225,230
,共9页
方向志%张扬%黄天丰%高巨
方嚮誌%張颺%黃天豐%高巨
방향지%장양%황천봉%고거
5-羟色胺受体拮抗剂%氟哌利多%术后恶心呕吐%Meta分析
5-羥色胺受體拮抗劑%氟哌利多%術後噁心嘔吐%Meta分析
5-간색알수체길항제%불고리다%술후악심구토%Meta분석
5-hydroxytryptamine receptor antagonist%Droperidol%Postoperative nausea and vomiting%Meta-analysis
目的 采用Meta分析比较5-羟色胺(5-hydroxytryptamine,5-HT3)受体拮抗剂与氟哌利多预防术后恶心呕吐(postoperative nausea and vomiting,PONV)的效果. 方法 检索Cochrane图书馆、Pubmed、EMBASE、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、重庆维普中文科技期刊全文数据库(VIP)、万方数据库,检索时间从建库至2013年9月.收集所有比较5-HT3受体拮抗剂与氟哌利多用于预防全麻PONV的文献.采用Cochrane协作网系统评价法评价纳入文献的质量,采用RevMan 5.1软件对收集的患者资料进行Meta分析评价. 结果 共纳入17项随机对照试验(randomized controlled trial,RCT),1 823例患者.Meta分析结果显示:与氟哌利多比较,5-HT3受体拮抗剂能降低全麻患者PONV(术后0～24 h)[比值比(RR)=0.49,95％可信区间(CI)=0.39～0.63]与呕吐(RR=0.54,95％CI=0.43～0.67)的发生率.亚组分析结果表明,昂丹司琼预防PONV(RR=0.67,95％CI=0.47～0.96)与呕吐(RR=0.56,95％CI=0.39～0.82)的发生较氟哌利多更好;格拉司琼预防PONV (RR=0.42,95％CI=0.30～0.58)与呕吐(RR=0.58,95％CI=0.42～0.81)的发生较氟哌利多更好.5-HT3受体拮抗剂与氟哌利多预防术后恶心的效果相当(RR=0.89,95％CI=0.77～1.04).昂丹司琼(RR=0.88,95％CI=0.67～1.14)或格拉司琼(RR=0.94,95％CI=0.75～1.17)与氟哌利多预防术后恶心的效果相当.与氟哌利多比较较,5-HT3受体拮抗剂组头痛发生率明显增加(RR=1.44,95％CI=1.12～1.84);5-HT3受体拮抗剂与氟哌利多术后头晕(RR=I.19,95％CI=0.88～1.62)、嗜睡(RR=1.24,95％CI=0.34～4.49)的发生率相同. 结论 与氟哌利多比较,5-HT3拮抗剂预防全麻患者PONV效果较好.
目的 採用Meta分析比較5-羥色胺(5-hydroxytryptamine,5-HT3)受體拮抗劑與氟哌利多預防術後噁心嘔吐(postoperative nausea and vomiting,PONV)的效果. 方法 檢索Cochrane圖書館、Pubmed、EMBASE、中國生物醫學文獻數據庫(CBM)、中國學術期刊全文數據庫(CNKI)、重慶維普中文科技期刊全文數據庫(VIP)、萬方數據庫,檢索時間從建庫至2013年9月.收集所有比較5-HT3受體拮抗劑與氟哌利多用于預防全痳PONV的文獻.採用Cochrane協作網繫統評價法評價納入文獻的質量,採用RevMan 5.1軟件對收集的患者資料進行Meta分析評價. 結果 共納入17項隨機對照試驗(randomized controlled trial,RCT),1 823例患者.Meta分析結果顯示:與氟哌利多比較,5-HT3受體拮抗劑能降低全痳患者PONV(術後0～24 h)[比值比(RR)=0.49,95％可信區間(CI)=0.39～0.63]與嘔吐(RR=0.54,95％CI=0.43～0.67)的髮生率.亞組分析結果錶明,昂丹司瓊預防PONV(RR=0.67,95％CI=0.47～0.96)與嘔吐(RR=0.56,95％CI=0.39～0.82)的髮生較氟哌利多更好;格拉司瓊預防PONV (RR=0.42,95％CI=0.30～0.58)與嘔吐(RR=0.58,95％CI=0.42～0.81)的髮生較氟哌利多更好.5-HT3受體拮抗劑與氟哌利多預防術後噁心的效果相噹(RR=0.89,95％CI=0.77～1.04).昂丹司瓊(RR=0.88,95％CI=0.67～1.14)或格拉司瓊(RR=0.94,95％CI=0.75～1.17)與氟哌利多預防術後噁心的效果相噹.與氟哌利多比較較,5-HT3受體拮抗劑組頭痛髮生率明顯增加(RR=1.44,95％CI=1.12～1.84);5-HT3受體拮抗劑與氟哌利多術後頭暈(RR=I.19,95％CI=0.88～1.62)、嗜睡(RR=1.24,95％CI=0.34～4.49)的髮生率相同. 結論 與氟哌利多比較,5-HT3拮抗劑預防全痳患者PONV效果較好.
목적 채용Meta분석비교5-간색알(5-hydroxytryptamine,5-HT3)수체길항제여불고리다예방술후악심구토(postoperative nausea and vomiting,PONV)적효과. 방법 검색Cochrane도서관、Pubmed、EMBASE、중국생물의학문헌수거고(CBM)、중국학술기간전문수거고(CNKI)、중경유보중문과기기간전문수거고(VIP)、만방수거고,검색시간종건고지2013년9월.수집소유비교5-HT3수체길항제여불고리다용우예방전마PONV적문헌.채용Cochrane협작망계통평개법평개납입문헌적질량,채용RevMan 5.1연건대수집적환자자료진행Meta분석평개. 결과 공납입17항수궤대조시험(randomized controlled trial,RCT),1 823례환자.Meta분석결과현시:여불고리다비교,5-HT3수체길항제능강저전마환자PONV(술후0～24 h)[비치비(RR)=0.49,95％가신구간(CI)=0.39～0.63]여구토(RR=0.54,95％CI=0.43～0.67)적발생솔.아조분석결과표명,앙단사경예방PONV(RR=0.67,95％CI=0.47～0.96)여구토(RR=0.56,95％CI=0.39～0.82)적발생교불고리다경호;격랍사경예방PONV (RR=0.42,95％CI=0.30～0.58)여구토(RR=0.58,95％CI=0.42～0.81)적발생교불고리다경호.5-HT3수체길항제여불고리다예방술후악심적효과상당(RR=0.89,95％CI=0.77～1.04).앙단사경(RR=0.88,95％CI=0.67～1.14)혹격랍사경(RR=0.94,95％CI=0.75～1.17)여불고리다예방술후악심적효과상당.여불고리다비교교,5-HT3수체길항제조두통발생솔명현증가(RR=1.44,95％CI=1.12～1.84);5-HT3수체길항제여불고리다술후두훈(RR=I.19,95％CI=0.88～1.62)、기수(RR=1.24,95％CI=0.34～4.49)적발생솔상동. 결론 여불고리다비교,5-HT3길항제예방전마환자PONV효과교호.
Objective To systematically review the efficacy of 5-hydroxytryptamine (5-HT3) receptor antagonist and droperidol for prevention of postoperative nausea and vomiting (PONV).Methods We searched the PubMed,EMBase,Cochrane library,Wanfang Database,CNKl,VIP and Chinese Biomedical Datebase for all randomized controlled trials about the efficacy of 5-HT3 receptor antagonist versus droperidol for prevention of PONV after general anesthesia.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.1 software.Results A total of 17 randomized controlled trials involving 1 823 patients were included.Compared with droperidol,the incidence of PONV (RR=0.49,95％CI=0.39-0.63) and vomiting (RR=0.54,95％CI=0.43-0.67) in the 5-HT3 receptor antagonist group was lower.Ondansetron is more effective than droperidol in reducing PONV (RR=0.48,95％CI=0.25-0.92 or vomiting (RR=0.48,95％CI=0.30-0.77),granisetron is more effective than droperidol in reducing PONV(RR=0.27,95％CI=0.17-0.438) or vomiting (RR=0.47,95％CI=0.30-0.74).5-HT3 receptor antagonist group was no more effective than droperidol for prevention of nausea(RR=0.89,95％ CI =0.77-1.04),ondansetron (RR =0.80,95％ CI =0.52-1.24)or granisetron (RR =0.90,95％ CI =0.63-1.28) could not significantly lessen the incidence of nausea compared with droperidol.Compared with droperidol,the incidence of headache (RR=1.44,95％ CI=1.12-1.84) in 5-HT3 receptor antagonist group was higher,there were no significant changes in the incidence of dizziness (RR=I.19,95％CI=0.88-1.62) and drowsiness (RR=1.24,95％C1=0.34-4.49).Conclusions The efficacy of 5-HT3 receptor antagonist is better than droperidol in the prevention of PONV after general anesthesia.
