依托咪酯-芬太尼类药物在老年胃镜检查应用的Meta分析

发布时间：2018-06-05 20:55

本文选题：依托咪酯 + 丙泊酚　；参考：《中国内镜杂志》2017年01期

【摘要】：目的 Meta分析依托咪酯和丙泊酚分别联合芬太尼类药物用于老年胃镜检查的麻醉效果及安全性。方法计算机检索Cochrane图书馆、Pub Med、Embase、中国生物医学文献数据库(CBM)、中国知网、维普资讯网和万方数据库等建库至2016年发表的关于依托咪酯-芬太尼类药物用于老年无痛胃镜术的随机对照试验(RCT),按照Jadad量表评价纳入研究的质量和提取资料,采用Rev Man 5.3软件进行统计分析。结果 11篇RCT(1 535例患者)纳入分析,依托咪酯组(E组)765例,丙泊酚组(P组)770例。依托咪酯组患者心率(HR)[加权均数差(WMD)=2.25,95%CI(0.93,3.56),P=0.001]和平均动脉压(MAP)[WMD=9.09,95%CI(7.60,10.57),P=0.000]的变化幅度较丙泊酚组小,发生低氧血症[OR^=0.46,95%CI(0.32,0.65),P=0.000]的风险较丙泊酚组低,差异有统计学意义;不良反应的发生方面,依托咪酯组发生呼吸暂停[OR^=0.26,95%CI(0.15,0.48),P=0.000]、注射痛[OR^=0.02,95%CI(0.01,0.05),P=0.000]的风险较丙泊酚组低,发生恶心呕吐[OR^=3.44,95%CI(2.03,5.84),P=0.000]、肌阵挛[OR^=8.14,95%CI(4.18,15.87),P=0.000]的风险较丙泊酚组高,差异有统计学意义。结论依托咪酯联合芬太尼类药物用于老年无痛胃镜术能较好地保持循环系统稳定,是一种安全有效的麻醉方案。
[Abstract]:Objective Meta to analyze the anesthetic effect and safety of etomidate and propofol combined with fentanyl for geriatric gastroscopy respectively. Methods computer retrieval Cochrane library, Pub Med, Embase, Chinese biomedical literature database (CBM), Chinese knowledge network, VP information network and Wanfang database were published to 2016. The randomized controlled trial (RCT) of the tuomomate fentanyl used for senile painless gastroscopy (RCT) was used to evaluate the quality and extraction data of the study according to the Jadad scale. The results were analyzed by Rev Man 5.3 software. Results 11 RCT (1535 patients) were analyzed, 765 cases of etomidate group (Group E), 770 cases of propofol group (P group). Heart rate (HR) [weighted mean number difference (WMD) =2.25,95%CI (0.93,3.56), P=0.001] and mean arterial pressure (MAP) [WMD=9.09,95%CI (7.60,10.57), P=0.000] is smaller than propofol group, hypoxemia [OR^=0.46,95%CI (0.32,0.65), P=0.000] risk is lower than propofol group, the difference is statistically significant; side effects of adverse reactions, relying on [OR^=0.26,95%CI (0.15,0.48), P=0.000], [OR^=0.02,95%CI (0.01,0.05) and P=0.000] were lower in the IMI group than in the propofol group. There was nausea and vomiting [OR^=3.44,95%CI (2.03,5.84), P=0.000], and myoclonus [OR^=8.14,95%CI (4.18,15.87). The risk of P=0.000] was higher than the propofol group. The difference was statistically significant. The conclusion was statistically significant. The difference was statistically significant. The difference was statistically significant. The combination of imidate and fentanyl in elderly painless gastroscopy can maintain the stability of the circulatory system. It is a safe and effective anesthesia program.
【作者单位】：西南医科大学护理学院;西南医科大学附属医院胃肠外科;
【基金】：四川省科技厅资助项目(No:2016SZ0062)
【分类号】：R573

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