CAJ | 학술논문

目的：系统评价帕洛诺司琼联合地塞米松预防术后恶心呕吐(PONV)的疗效，为合理制定PONV的预防方案提供高质量证据。方法计算机检索PubMed、The Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库、维普数据库，检索时限均为建库至2014年11月，收集帕洛诺司琼联合地塞米松预防PONV的随机对照试验。由2位评价者按纳入和排除标准独立筛选文献、提取资料和质量评价后，采用Rev Man 5.2软件进行Meta分析。结果纳入6项随机对照试验，共466例患者。 Meta分析结果显示，帕洛诺司琼可有效降低PONV的发病率；帕洛诺司琼联合地塞米松较单用帕洛诺司琼更能降低术后恶心的发病率，亦能有效降低呕吐的发病率；联合用药较单一用药不能降低接受长时程手术的女性患者PONV的发病率。结论帕洛诺司琼联合地塞米松可降低PONV的发生率，但对合并多种危险因素者，联合用药较单一用药无优势，受纳入研究质量和数量限制，上述结论需更多高质量的随机对照试验加以验证。
목적：계통평개파락낙사경연합지새미송예방술후악심구토(PONV)적료효，위합리제정PONV적예방방안제공고질량증거。방법계산궤검색PubMed、The Cochrane Library、중국생물의학문헌수거고、중국지망、만방수거고、유보수거고，검색시한균위건고지2014년11월，수집파락낙사경연합지새미송예방PONV적수궤대조시험。유2위평개자안납입화배제표준독립사선문헌、제취자료화질량평개후，채용Rev Man 5.2연건진행Meta분석。결과납입6항수궤대조시험，공466례환자。 Meta분석결과현시，파락낙사경가유효강저PONV적발병솔；파락낙사경연합지새미송교단용파락낙사경경능강저술후악심적발병솔，역능유효강저구토적발병솔；연합용약교단일용약불능강저접수장시정수술적녀성환자PONV적발병솔。결론파락낙사경연합지새미송가강저PONV적발생솔，단대합병다충위험인소자，연합용약교단일용약무우세，수납입연구질량화수량한제，상술결론수경다고질량적수궤대조시험가이험증。
Objective To evaluate the efficacy of palonosetron with dexamethasone for prevention of postoperative nau-sea and vomiting(PONV),so as to provide high quality evidence for formulating the rational prevention of PONV. Meth-ods The randomized controlled trails (RCTs) on palonosetron with dexamethasone for prevention were searched in PubMed,the Cochrane Library,CBM,CNKI,WanFang Data and VIP from the date of their establishment to November 2014.According to the inclusion and exclusion criteria,two reviewers independently screened the studies,extracted the data and assessed the quality.Then Rev Man 5.2 software was used for Meta-analysis. Results A total of 6 RCTs in-volving 466 patients were included.The results of Meta-analysis suggested that,palonosetron alone could decrease the incidence of PONV,palonosetron with dexamethasone could decrease both the incidence of nausea and vomiting.Howev-er,for female patient who accepted long time operation,the combination therapy of palonosetron with dexamethasone did not reduce the incidence of nausea and vomiting when compared with palonosetron alone. Conclusion Based on the current studies,palonosetron with dexamethasone can decrease the incidence of PONV,but combination therapy com-pared with monotherapy no advantage for patients with high risk factors.Due to the limited quality and quantity of the included studies,more high quality RCTs are required to further verify this conclusion.