华法林对拔牙术后出血并发症影响的Meta分析

发布时间：2019-06-25 16:55

【摘要】：目的系统评价华法林对拔牙术后出血的影响。方法计算机检索Pub Med、EMbase、The Cochrane Library(2016年9期)、CNKI、VIP和Wan Fang Data数据库以及中国国家药品不良反应监测系统和美国FDA药品不良反应监测系统,搜集关于华法林对拔牙术后出血影响的随机对照试验和队列研究,检索时限均为建库至2016年9月30日。由两位评价者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入8个研究,其中3个为RCTs,5个为队列研究。Meta分析结果显示:停用或减量华法林组与不停用华法林组在拔牙术后出血并发症发生率方面,其差异无统计学意义[RCTs:RR=0.86,95%CI(0.49,1.51),P=0.60;队列研究:RR=0.67,95%CI(0.45,1.01),P=0.06]。结论当前证据表明,停服华法林与否和拔牙术后出血并发症并无具有统计学意义的相关性。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
[Abstract]:Objective To evaluate the effect of warfarin on post-extraction bleeding. Methods A randomized controlled trial and cohort study on the effects of warfarin on post-extraction bleeding was collected by computer-based search for Pub Med, EMbase, The Cochrane Library (September 2016), the CNKI, the VIP and the Wan Fang Data database, as well as the China National Drug Reaction Monitoring System and the US FDA ADR Monitoring System. The search time limit is from the construction bank to September 30,2016. A Meta-analysis was conducted using the Rev Man 5.3 software, following the independent screening of the literature, extraction data and evaluation of the bias risk of the study by the two evaluators. The results were included in 8 studies, of which 3 were RCTs and 5 were cohort studies. The results of the meta-analysis showed that there was no significant difference in the incidence of bleeding complications after tooth extraction (RCTs: RR = 0.86,95% CI (0.49, 1.51), P = 0.60; cohort study: RR = 0.67,95% CI (0.45, 1.01), P = 0.06]. Conclusion The present evidence indicates that there is no statistically significant correlation between the presence of warfarin and the complications of bleeding after tooth extraction. The above conclusions have yet to be validated by a greater number of high-quality studies, subject to the limitations of the number and quality of studies included.
【作者单位】：天津医科大学口腔医院;
【分类号】：R782.11

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