氟哌啶醇预防术后恶心呕吐的Meta分析

发布时间：2018-04-08 15:03

本文选题：氟哌啶醇　切入点：预防　出处：《中国药房》2016年36期

【摘要】：目的:系统评价氟哌啶醇预防术后恶心呕吐(PONV)的有效性和安全性,为临床"超说明书用药"提供循证参考。方法:计算机检索Medline(Pub Med)、EMBase(Ovid)、Cochrane图书馆、Clinical trials、中国生物医学文献数据库、相关期刊论文、中文科技期刊数据库和万方数据库,全面收集氟哌啶醇单用或者联合常规止吐方案对比安慰剂或阳性药物或常规止吐方案单用预防PONV的随机对照试验(RCT),提取资料并采用改良的Jadad评分标准评价文献质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入15项RCT,合计2 629例患者。Meta分析结果显示,与安慰剂比较,氟哌啶醇可以显著提高患者24 h内PONV完全控制率[RR=1.69,95%CI(1.35,2.12),P0.001],而与昂丹司琼/托烷司琼比较差异无统计学意义[RR=1.00,95%CI(0.89,1.12),P=0.99];与单用常规止吐方案比较,氟哌啶醇联合常规止吐方案可以显著提高患者24 h内PONV完全控制率[RR=1.21,95%CI(1.06,1.39),P=0.006]和48 h内PONV完全控制率[OR=7.58,95%CI(3.59,16.02),P0.001]。两组患者锥体外系反应发生率[RR=3.05,95%CI(0.74,12.67),P=0.12]、镇静发生率[RR=1.27,95%CI(0.73,2.20),P=0.39]和Q-T间期延长发生率[RR=1.06,95%CI(0.77,1.48),P=0.71]比较差异均无统计学意义。结论:氟哌啶醇可有效预防PONV,对24 h和48 h内PONV均有良好的控制效果,且不增加患者锥体外系反应、镇静和Q-T间期延长等不良反应的发生。
[Abstract]:Objective: to evaluate the efficacy and safety of haloperidol in the prevention of postoperative nausea and vomiting (PONVV), and to provide evidence-based reference for clinical hyperscript.Methods: a computer search was conducted to search the Medline(Pub Medtros Cochrane Library, the Chinese Biomedical Literature Database, the full text Database of Chinese Journals, the Chinese Sci-tech Journals Database and the Wanfang Database.To collect haloperidol alone or in combination with routine antiemesis regimen to compare placebo or positive drug or routine antiemesis regimen with randomized controlled trial for prevention of PONV. The data were extracted and the quality of literature was evaluated by modified Jadad scoring standard.Meta analysis was carried out with Rev Man 5.3.Results: a total of 15 RCTs were included, a total of 2 629 patients. Meta-analysis showed that compared with placebo,Haloperidol combined with routine antiemesis regimen could significantly improve the complete control rate of PONV within 24 h [RRN 1.21 ~ 95 CI 1.06 ~ 1.39 P0. 006] and PONV complete control rate within 48 h [OR7.589 ~ 95CII 3.59 ~ 16.02% P0.001].Conclusion: haloperidol can effectively prevent PONV from occurring in 24 h and 48 h, and does not increase the incidence of extrapyramidal reaction, sedation and prolongation of Q-T interval.
【作者单位】：首都医科大学附属北京世纪坛医院药剂科;北京大学药学院药事管理与临床药学系;
【分类号】：R619

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