利伐沙班用于骨科术后患者静脉血栓栓塞预防有效性和安全性的Meta分析

发布时间：2018-08-05 19:42

【摘要】：目的评价利伐沙班在用于骨科术后患者静脉血栓栓塞预防方面的有效性和安全性。方法系统检索Pub Med、Em Base、Cochrane Library、Web of Science、Clinical Trials、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库,检索时间均从建库至2016年8月。筛选出利伐沙班单药或者联合其他常规用药用于骨科术后患者静脉血栓预防的所有随机对照试验(RCTs),比较总静脉血栓栓塞、严重静脉血栓栓塞、深静脉血栓、肺栓塞、全因死亡、症状性静脉血栓栓塞等有效性结局及出血、大出血、临床相关非大出血、轻微出血、伤口并发症等安全性结局事件的发生率。结果以相对危险系数(RR)及其95%置信区间(CI)表示,用Rev Man 5.3软件进行Meta分析。结果共纳入32项RCTs研究,涉及17061例患者,其中试验组9167例,对照组7894例。Meta分析结果显示,与低分子肝素相比,在症状性静脉血栓栓塞、总静脉血栓栓塞、严重静脉血栓栓塞、深静脉血栓事件发生率方面,试验组显著低于对照组(P0.05),其他安全性指标差异均无统计学意义;与阿司匹林相比,在总静脉血栓栓塞、深静脉血栓事件发生率方面,试验组显著低于对照组(P0.05),其他安全性指标差异均无统计学意义;与阿哌沙班相比,在有效性及安全性方面差异均无统计学意义。结论利伐沙班用于骨科术后患者静脉血栓栓塞预防的疗效显著优于低分子肝素及阿司匹林,且不会显著增加出血、伤口并发症等风险。
[Abstract]:Objective to evaluate the efficacy and safety of Lipashaban in the prevention of venous thromboembolism after orthopedic surgery. Methods A systematic search was conducted for the Pub Meden Em Base Library Web of Science Clinical Trials, and the (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang database. The retrieval time was from the establishment of the database to August 2016. All randomized controlled trials (RCTs), which were selected for the prevention of venous thrombosis in orthopedic patients with single drug or other conventional drugs, were compared with total venous thromboembolism, severe venous thromboembolism, deep venous thrombosis, pulmonary embolism, and death. The effective outcome of symptomatic venous thromboembolism and the incidence of safe outcome events such as bleeding, massive hemorrhage, clinical associated non-massive hemorrhage, minor bleeding, wound complications, etc. Results the relative risk coefficient (RR) and its 95% confidence interval (CI) were used for Meta analysis with Rev Man 5.3 software. Results A total of 32 RCTs studies involved 17061 patients, including 9167 patients in the trial group and 7894 patients in the control group. Meta-analysis showed that compared with low molecular weight heparin, symptomatic venous thromboembolism, total venous thromboembolism, and severe venous thromboembolism were found in patients with symptomatic venous thromboembolism, total venous thromboembolism and severe venous thromboembolism. The incidence of deep venous thromboembolism in the trial group was significantly lower than that in the control group (P0.05), and there was no significant difference in other safety indicators. Compared with aspirin, the incidence of total venous thromboembolism and deep venous thromboembolism in the trial group was significantly lower than that in the control group. The experimental group was significantly lower than the control group (P0.05), other safety indicators were not statistically significant; compared with the piperazaban, there was no significant difference in efficacy and safety. Conclusion Levasaban is more effective than low molecular weight heparin and aspirin in the prevention of venous thromboembolism after orthopedic surgery and does not increase the risk of bleeding and wound complications.
【作者单位】：北京大学第三医院药剂科;
【分类号】：R687.3

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