摘要
目的采用Meta分析方法评价地佐辛与芬太尼用于无痛人工流产手术的有效性和安全性。方法应用计算机检索PubMed、EMbase、Cochrane Library、维普、中国知网和万方数据库自从建库至2014年7月间发表的关于地佐辛、芬太尼用于无痛人工流产手术随机对照试验的文章,对符合纳入标准的研究进行资料提取和文献质量评价,应用RevMan 5.3统计学软件进行Meta分析。结果共纳入12篇中文文献,研究对象980例,Meta分析结果如下。1安全性:地佐辛组与芬太尼组间术后苏醒时间[标准化均数差值(SMD)=-0.26,95%CI为-0.39^-0.13]、术中脉搏血氧饱和度下降幅度(SMD=1.41,95%CI为0.75~2.06)、呼吸抑制发生例数[相对危险度(RR)=0.20,95%CI为0.12~0.34]的差异均有统计学意义(P值均<0.01)。2有效性:地佐辛组与芬太尼组间术中发生体动的例数(RR=0.97,95%CI为0.66~1.44)、术后下腹部疼痛视觉模拟评分(SMD=-1.46,95%CI为-2.97~0.05)、出现宫缩痛的例数(RR=0.77,95%CI为0.43~1.39)、丙泊酚总用量(SMD=0.08,95%CI为-0.39~0.55)的差异均无统计学(P值均>0.05)。3不良反应:地佐辛组与芬太尼组间术后恶心呕吐患者例数的差异有统计学意义(RR=0.33,95%CI为0.19~0.56,P<0.01)。结论依据现有文献证据,地佐辛用于无痛人工流产手术的镇痛效果与芬太尼相似,对呼吸系统的抑制作用较芬太尼小,不良反应发生率低,是有效可靠的镇痛药物。鉴于纳入的研究较少、样本量小且质量不高,故仍需开展大样本、多中心、高质量的随机对照试验以进一步论证。
Objective To evaluate the efficacy and safety of dezocine and fentanyl used in painless induced abortion by meta analysis. Methods The databases of PubMed, EMbase, Cochrane Library, VIP, China National Knowledge Infrastructure （CNKI） and Wanfang were searched for randomized controlled trials （ROTs） about the efficacy and safety of dezocine and fentanyl in painless induced abortion published from the databases established ment July 2014. Then the literatures of eligible RCTs were extracted and given a meta-analysis by RevMan 5.3 software. Results Twelve Chinese literatures involving 980 patients were included in this study. The results of meta analysis between the patients with intravenous injection of dezocine and the ones with fentanyl were as follows：①Safety there were significant differences in terms of postoperative recovery time （SMD= -0.26, 95%CI=-0.39- -0.13, P〈0.01）,intraoperative pulse oxygen saturation （SMD=1.41, 95%CI：0.75- 2.06, P〈0.01 ）, and respiratory depression cases （RR = 0.20, 95 % CI = 0. 12 - 0.34, P〈0.01 ）. ②Efficacy： there was no significant difference in terms of intraoperative body movement cases （RR = 0.97, 95 % Cl= 0.66- 1.44, P〉0.05）, Visual analogue score for pain after recovery （SMD = - 1.46, 95 % CI ： - 2.97 - 0.05, P 〉 0.05）, uterine contraction pain cases （RR = 0.77, 95% CI=0. 43-1.39, P〉0.05） or propofol consumption （ SMD = 0.08, 95 % CI ; - 0.39 - 0.55, P〉0.05）. ③Adverse reactions： there was significant difference in the incidence of postoperative nausea and vomiting （RR = 0.33, 95% CI=0. 19- 0.56, P〈0.01）. Conclusion Based on the results of existing literatures, compared with fentanyl, dezocine is a reliable and effective analgesic drug with lower incidences of respiratory depression and adverse reaction in painless artificial abortion. In view of small-sample, low-quality, small amounts of ROT literatures published, it is still necessary to carry out largesample, multicenter, high-quality ROTs for further r
出处
《上海医学》
CAS
CSCD
北大核心
2015年第12期913-919,共7页
Shanghai Medical Journal
