中国医药导报
中國醫藥導報
중국의약도보
China Medical Herald
2015年
31期
123-127,134
,共6页
散小虎%杨进国%朱辉%张在斌
散小虎%楊進國%硃輝%張在斌
산소호%양진국%주휘%장재빈
地佐辛%芬太尼%人工流产术%随机对照试验%Meta分析
地佐辛%芬太尼%人工流產術%隨機對照試驗%Meta分析
지좌신%분태니%인공유산술%수궤대조시험%Meta분석
Dezoncine%Fentanil%Painless induced abortion%Randomized controlled trial%Meta analysis
目的：采用系统评价地佐辛和芬太尼分别复合丙泊酚用于无痛人流术的效果和安全性。方法电子检索Cochrane图书馆、Pubmed、中国知网、万方数据库、维普资讯网中从建库到2015年1月发表的关于地佐辛和芬太尼分别复合丙泊酚用于无痛人流的随机对照试验，根据Cochrane系统评价的方法评价纳入研究的质量和提取资料，采用RevMan 5.2软件进行统计分析。结果共纳入15篇临床随机对照试验共计1262例患者。分析结果显示：①有效性：与芬太尼复合丙泊酚组比较，地佐辛复合组能够显著减少丙泊酚的总用量(MD=-29.36，95%CI-41.60~-17.12，P=0.0100)，缩短术后苏醒时间(MD=-1.62，95%CI-2.06~-1.18，P<0.0001)；②不良反应：术后地佐辛复合丙泊酚组恶心呕吐、呼吸抑制、头晕的发生率均低于芬太尼组复合丙泊酚组，差异有统计学意义(OR =0.28、0.20、0.43，95%CI分别为0.17~0.46、0.13~0.31、0.26~0.73)，术中体动的发生率两组比较，差异无统计学意义(OR=0.64，95豫CI 0.40~1.04，P=0.07)。结论现有临床证据表明，地佐辛复合丙泊酚与芬太尼复合丙泊酚用于无痛人流术相比，可以缩短苏醒时间，减少丙泊酚的总用量及不良反应的发生，其效果更好、安全性更高。
目的：採用繫統評價地佐辛和芬太尼分彆複閤丙泊酚用于無痛人流術的效果和安全性。方法電子檢索Cochrane圖書館、Pubmed、中國知網、萬方數據庫、維普資訊網中從建庫到2015年1月髮錶的關于地佐辛和芬太尼分彆複閤丙泊酚用于無痛人流的隨機對照試驗，根據Cochrane繫統評價的方法評價納入研究的質量和提取資料，採用RevMan 5.2軟件進行統計分析。結果共納入15篇臨床隨機對照試驗共計1262例患者。分析結果顯示：①有效性：與芬太尼複閤丙泊酚組比較，地佐辛複閤組能夠顯著減少丙泊酚的總用量(MD=-29.36，95%CI-41.60~-17.12，P=0.0100)，縮短術後囌醒時間(MD=-1.62，95%CI-2.06~-1.18，P<0.0001)；②不良反應：術後地佐辛複閤丙泊酚組噁心嘔吐、呼吸抑製、頭暈的髮生率均低于芬太尼組複閤丙泊酚組，差異有統計學意義(OR =0.28、0.20、0.43，95%CI分彆為0.17~0.46、0.13~0.31、0.26~0.73)，術中體動的髮生率兩組比較，差異無統計學意義(OR=0.64，95豫CI 0.40~1.04，P=0.07)。結論現有臨床證據錶明，地佐辛複閤丙泊酚與芬太尼複閤丙泊酚用于無痛人流術相比，可以縮短囌醒時間，減少丙泊酚的總用量及不良反應的髮生，其效果更好、安全性更高。
목적：채용계통평개지좌신화분태니분별복합병박분용우무통인류술적효과화안전성。방법전자검색Cochrane도서관、Pubmed、중국지망、만방수거고、유보자신망중종건고도2015년1월발표적관우지좌신화분태니분별복합병박분용우무통인류적수궤대조시험，근거Cochrane계통평개적방법평개납입연구적질량화제취자료，채용RevMan 5.2연건진행통계분석。결과공납입15편림상수궤대조시험공계1262례환자。분석결과현시：①유효성：여분태니복합병박분조비교，지좌신복합조능구현저감소병박분적총용량(MD=-29.36，95%CI-41.60~-17.12，P=0.0100)，축단술후소성시간(MD=-1.62，95%CI-2.06~-1.18，P<0.0001)；②불량반응：술후지좌신복합병박분조악심구토、호흡억제、두훈적발생솔균저우분태니조복합병박분조，차이유통계학의의(OR =0.28、0.20、0.43，95%CI분별위0.17~0.46、0.13~0.31、0.26~0.73)，술중체동적발생솔량조비교，차이무통계학의의(OR=0.64，95예CI 0.40~1.04，P=0.07)。결론현유림상증거표명，지좌신복합병박분여분태니복합병박분용우무통인류술상비，가이축단소성시간，감소병박분적총용량급불량반응적발생，기효과경호、안전성경고。
Objective To systematically evaluate the safty and effect of Dezocine orFentanil with Propofol anesthesia for painless induced abortion. Methods A search about randomized controlled trial of Dezocine orFentanil with Propofol anesthesia for painless induced abortion was performed within Cochrane library, Pubmed, CINK, Wanfang Data, VIP from creating database to January 2015. The data were evaluated strictly and the extracted data were analyzed by RevMan 5.2. Results 15 randomized controlled trials involving 1262 patients were included. The results of analyses showed that: ①Efficacy: compared with Fentani with Propofol group, the total dosage of Propofol in Dezocine with Propofol group significantly decreased (MD = -29.36, 95%CI -41.60 to -17.12, P = 0.0100), the recovery time of patients were significantly shorter (MD = -1.62, 95%CI -2.06 to -1.18, P < 0.0001). ②Adverse reaction: after the surgery, the incidence of nausea and vomiting, breath depress, dizziness in Dezocine with Propofol group were lower than those in Fentani with Propofol group (OR = 0.28, 0.20, 0.43,95%CI were 0.17-0.46, 0.13-0.31, 0.26-0.73), but there was no significant difference between the two groups in patients' body response caused by operating stimulation (OR=0.64, 95%CI 0.40 - 1.04, P = 0.07). Conclusion The limited current evidence shows that Dezocine is effective alternative to Fentanyl when administered during induced abortion operation, and Dezocine is associated with a shorter anesthesia recovery time, a lower dosage of Propofol and a lower incidence of postoperative adverse reaction compared with Fentanyl.
