护理研究
護理研究
호리연구
Chinese Nursing Research
2015年
31期
3853-3859
,共7页
沐舒坦%剂量%肺癌%手术%疗效%安全性%Meta 分析
沐舒坦%劑量%肺癌%手術%療效%安全性%Meta 分析
목서탄%제량%폐암%수술%료효%안전성%Meta 분석
ambroxol%dose%lung cancer%surgery%curative effect%safety%Meta analysis
[目的]系统评价不同剂量沐舒坦(盐酸氨溴索)在肺癌围术期应用的疗效及安全性。[方法]计算机检索 MEDLINE、EMbase、Cochrane 随机对照试验数据库、中国知网、维普、中国生物医学文献数据库、万方等数据库中关于不同剂量沐舒坦在肺癌围术期应用的随机或半随机对照研究,检索时限均从建库至2014年8月1日,按照 Cochrane 系统评价方法,对纳入的研究进行资料提取和质量评价,采用 RevMan5.3软件进行 Meta 分析。[结果]最终共纳入7篇中文文献,包括523例病人(大剂量组271例,常规剂量组252例)。Meta 分析结果显示：大剂量氨溴索显著降低肺不张发生率相对风险比[RR =0.22,5%CI (0.12,0.41)]、肺部感染发生率相对风险比[RR=0.33,5%CI (0.21,0.53)]、总肺部并发症发生率相对风险比[RR=0.28,5%CI (0.20,0.40)],缩短抗生素使用时间[WMD =-1.69,5%CI (-2.19,-1.19)]和术后住院时间[WMD =-3.18,5%CI (-3.87,-2.48)]。沐舒坦大剂量组不良反应较常规剂量组常见,但差异均无统计学意义。[结论]大剂量氨溴索能有效地改善肺癌术后病人呼吸系统症状、降低肺部并发症发生率、保护围术期肺功能、加快病人康复,且比较安全。本研究证据强度较低,尚不能确定最佳剂量、用药时机及适应证,有待进一步研究。
[目的]繫統評價不同劑量沐舒坦(鹽痠氨溴索)在肺癌圍術期應用的療效及安全性。[方法]計算機檢索 MEDLINE、EMbase、Cochrane 隨機對照試驗數據庫、中國知網、維普、中國生物醫學文獻數據庫、萬方等數據庫中關于不同劑量沐舒坦在肺癌圍術期應用的隨機或半隨機對照研究,檢索時限均從建庫至2014年8月1日,按照 Cochrane 繫統評價方法,對納入的研究進行資料提取和質量評價,採用 RevMan5.3軟件進行 Meta 分析。[結果]最終共納入7篇中文文獻,包括523例病人(大劑量組271例,常規劑量組252例)。Meta 分析結果顯示：大劑量氨溴索顯著降低肺不張髮生率相對風險比[RR =0.22,5%CI (0.12,0.41)]、肺部感染髮生率相對風險比[RR=0.33,5%CI (0.21,0.53)]、總肺部併髮癥髮生率相對風險比[RR=0.28,5%CI (0.20,0.40)],縮短抗生素使用時間[WMD =-1.69,5%CI (-2.19,-1.19)]和術後住院時間[WMD =-3.18,5%CI (-3.87,-2.48)]。沐舒坦大劑量組不良反應較常規劑量組常見,但差異均無統計學意義。[結論]大劑量氨溴索能有效地改善肺癌術後病人呼吸繫統癥狀、降低肺部併髮癥髮生率、保護圍術期肺功能、加快病人康複,且比較安全。本研究證據彊度較低,尚不能確定最佳劑量、用藥時機及適應證,有待進一步研究。
[목적]계통평개불동제량목서탄(염산안추색)재폐암위술기응용적료효급안전성。[방법]계산궤검색 MEDLINE、EMbase、Cochrane 수궤대조시험수거고、중국지망、유보、중국생물의학문헌수거고、만방등수거고중관우불동제량목서탄재폐암위술기응용적수궤혹반수궤대조연구,검색시한균종건고지2014년8월1일,안조 Cochrane 계통평개방법,대납입적연구진행자료제취화질량평개,채용 RevMan5.3연건진행 Meta 분석。[결과]최종공납입7편중문문헌,포괄523례병인(대제량조271례,상규제량조252례)。Meta 분석결과현시：대제량안추색현저강저폐불장발생솔상대풍험비[RR =0.22,5%CI (0.12,0.41)]、폐부감염발생솔상대풍험비[RR=0.33,5%CI (0.21,0.53)]、총폐부병발증발생솔상대풍험비[RR=0.28,5%CI (0.20,0.40)],축단항생소사용시간[WMD =-1.69,5%CI (-2.19,-1.19)]화술후주원시간[WMD =-3.18,5%CI (-3.87,-2.48)]。목서탄대제량조불량반응교상규제량조상견,단차이균무통계학의의。[결론]대제량안추색능유효지개선폐암술후병인호흡계통증상、강저폐부병발증발생솔、보호위술기폐공능、가쾌병인강복,차비교안전。본연구증거강도교저,상불능학정최가제량、용약시궤급괄응증,유대진일보연구。
Objective:To systematically assess the curative effect and safety of different doses of ambroxol for lung cancer patients in perioperative period.Methods:The randomised or quasi randomized controlled trials RCTs)on the application of different doses of ambroxol for lung cancer patients in perioperative period were searched from the Cochrane Library,MEDLINE,Embase,CBM,CNKI,WanFang database from inception to August 1,2014.According to the Cochrane system evaluation method,the Data extraction and quality assess-ment were carried out in the included researches.The RevMan 5.3 software was used for meta analysis.Re-sults:Seven pieces of Chinese literatures were included and totally 523 patients (large dose group with 271 ca-ses,conventional dose group with 252 cases).Meta analysis results showed:Large dose of ambroxol significantly reduced the relative risk ratio of pulmonary atelectasis incidence[RR=0.22,5% CI (0.12,0.41)],relative risk ratio of pulmonary infection incidence[RR =0.33,5% CI (0.21,0.53),relative risk ratio of total pulmonary complications incidence[RR=0.28,5% CI (0.20,0.40)],shortened antibiotic use time[WMD=-1.69,5% CI (-2.1 9,-1.1 9)]and postoperative hospital time [WMD=-3.18,5% CI (-3.87,-2.48)].The incidence of adverse reactions of large doses of ambroxol group was higher than that in conventional dose group,but the difference were not statistically significant.Conclusion:Large dose ambroxol may improve the postoperative re-spiratory system symptoms,reduce pulmonary complications,protect the perioperative pulmonary function,ac-celerate the rehabilitation of patients and it was relatively safety.The evidence of this study was lower,still may not determine the optimal dosage,timing and indications,which need to be further studied.
