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的Meta分析

发布时间：2018-05-18 09:07

本文选题：地佐辛 + 芬太尼　；参考：《上海医学》2015年12期

【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,P0.01)。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。
[Abstract]:Objective to evaluate the efficacy and safety of dizosin and fentanyl in painless induced abortion by Meta analysis. Methods A computer-based search was carried out on PubMedus EMbase Cochrane Library, Weip, ChinaNet and Wanfang database on the use of dizosin and fentanyl in randomized controlled trials of painless induced abortion from the establishment of the database to July 2014. Data extraction and literature quality evaluation were carried out for the studies that met the inclusion criteria, and Meta analysis was carried out with RevMan 5.3 statistical software. Results 12 articles of Chinese literature were included. The results of meta-analysis of 980 patients were as follows: the postoperative recovery time between dizosin group and fentanyl group [standardized mean difference (SMD-0.2695 CI = -0.39 ~ 0.13], the decrease of pulse oxygen saturation during operation and the CI of SMD-1.41 + 95% CI were 0.752.06, and the number of cases of respiratory depression [ The relative risk was 0.2095 CI (0.120.34). There were significant differences in P value (P = 0.01) and validity (P = 0.01). The number of cases of intraoperative body movement between the dizosin group and fentanyl group was 0.660.67 / 95 CI = 0.661.44. The visual analogue score of postoperative lower abdominal pain (SMD-1.469595 CI = -2.97 / 5) was 0.05, and the incidence of uterine contractions was found in the patients with uterine contractions in Dizosin group and fentanyl group. There was no significant difference in the total dose of propofol and SMD-0.0895 CI (-0.39 卤0.55) between the two groups (P = 0.05 or 0.05). There was significant difference in the number of patients with postoperative nausea and vomiting between the dizoxin group and fentanyl group. Conclusion according to the available literature evidence, the analgesic effect of dizosin in painless induced abortion is similar to that of fentanyl, the inhibitory effect on respiratory system is less than that of fentanyl, and the incidence of adverse reactions is low. It is an effective and reliable analgesic drug. In view of the small number of samples and low quality, large sample, multi-center, high quality randomized controlled trials are needed for further demonstration.
【作者单位】：上海市普陀区利群医院麻醉科;
【分类号】：R169.42

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