保护性镇痛对截肢后幻肢痛发生率影响的Meta分析

发布时间：2018-06-12 10:58

本文选题：围术期 + 保护性镇痛　；参考：《中国康复理论与实践》2017年12期

【摘要】：目的系统评价保护性镇痛对截肢后幻肢痛发生率的影响。方法检索建库至2017年6月Cochrane Library、PubMed、Embase、Web of Science、OVID、Science Direct数据库,收集围术期保护性镇痛防治截肢后幻肢痛的临床研究进行评价。由两位独立研究人员根据纳入与排除标准筛选文献并进行质量评价后,提取文献中的相关资料,包括一般资料和幻肢痛发生率,利用RevMan 5.3软件进行Meta分析。结果最终筛选出6篇符合条件的文献。术后随访1个月期共纳入256例患者,其中对照组129例,实验组127例。术后随访6个月期共纳入232例患者,其中对照组118例,实验组114例。术后随访12个月期共纳入118例患者,其中对照组60例,实验组58例。采用围术期保护性镇痛方式进行干预后术后1个月[RD=-0.21,95%CI(-0.38,-0.04),Z=2.47,P=0.01]和术后6个月[RD=-0.28,95%CI(-0.52,-0.05),Z=2.37,P=0.02]的幻肢痛发生率低于对照组,而术后12个月的幻肢痛发病率两组之间无显著性差异[RD=-0.20,95%CI(-0.48,0.09),Z=1.35,P=0.18]。结论围术期保护性镇痛能够预防截肢后近期和中期幻肢痛的发生率,但远期效果需要做进一步观察。
[Abstract]:Objective to evaluate the effect of protective analgesia on the incidence of phantom limb pain after amputation. Methods the database of Cochrane Library PubMedus Embase of Science OVIDScience Direct was searched to evaluate the clinical study of perioperative protective analgesia in the prevention and treatment of phantom limb pain after amputation. After two independent researchers screened and evaluated the literature according to the inclusion and exclusion criteria, the relevant data, including general data and phantom limb pain incidence, were extracted and Meta-analysis was carried out with Revman 5.3 software. Results six eligible articles were screened out. 256 patients were followed up for 1 month, including 129 cases in the control group and 127 cases in the experimental group. A total of 232 patients were followed up for 6 months, including 118 in the control group and 114 in the experimental group. A total of 118 patients were followed up for 12 months, including 60 in the control group and 58 in the experimental group. The incidence of phantom pain at one month after intervention with perioperative protective analgesia was lower than that in the control group, but there was no significant difference between the two groups in the incidence of phantom pain at 12 months after operation [RD-0.38C- 0.04CI-0.20CI-0.49CI-0.28CI-0.52- 0.05P0.02], but there was no significant difference in the incidence of phantom pain between the two groups [RD-0.20C95CI-0.49CI-0.49CI-0.35P0. 18] after the intervention, there was no significant difference in the incidence of phantom pain between the two groups (RD-0.20CI-0.49CI-0.49CI-0.49CI-0.35P0. 18). The incidence of phantom pain in the two groups was lower than that in the control group. Conclusion Protective analgesia during perioperative period can prevent the incidence of phantom limb pain after amputation, but the long-term effect needs further observation.
【作者单位】：中国康复研究中心北京博爱医院麻醉科;首都医科大学康复医学院;中国康复研究中心北京博爱医院脊柱脊髓外科;
【分类号】：R687.5

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