美罗培南改良输注方式对比传统输注方式治疗严重感染疗效和安全性的Meta分析

发布时间：2018-04-17 04:21

本文选题：美罗培南 + 改良输注方式　；参考：《中国药房》2015年24期

【摘要】：目的:系统评价美罗培南改良输注方式(2~4 h输注或持续24 h输注)对比传统输注方式(0.5~1 h输注)治疗严重感染的疗效和安全性,以为临床治疗提供循证参考。方法:计算机检索Medline、相关期刊论文、中文科技期刊数据库、万方数据库,检索美罗培南改良输注方式(试验组)对比传统输注方式(对照组)治疗严重感染的系列研究,提取资料并评价质量后,采用Rev Man 5.0统计软件进行Meta分析。结果:共纳入13项临床研究,合计1 012例患者。Meta分析结果显示,试验组患者临床有效率[RR=1.25,95%CI(1.10,1.43),P0.001]和细菌清除率[RR=1.25,95%CI(1.05,1.48),P=0.01]显著高于对照组,而死亡率[RR=0.74,95%CI(0.46,1.18),P=0.21]和不良反应发生率[RR=0.81,95%CI(0.48,1.39),P=0.45]与对照组比较,差异无统计学意义。结论:与传统输注方式相比,延长或持续输注美罗培南可提高治疗严重感染的疗效,两者安全性相当。受纳入研究方法学质量的限制,该结论有待大样本、高质量的随机对照试验进一步验证。
[Abstract]:Objective: to evaluate the efficacy and safety of meropenem modified infusion for 4 h or 24 h) in the treatment of severe infection compared with the traditional method (0.5 h), so as to provide evidence based reference for clinical treatment.Methods: Medline, full text database of Chinese journals, database of Chinese scientific and technological journals, database of Wanfang, search of the modified meropenem infusion method (experimental group) for treatment of severe infection compared with traditional infusion (control group) were searched.After extracting the data and evaluating the quality, Meta analysis was carried out with Rev Man 5.0 statistical software.Results: a total of 1 012 patients. Meta-analysis results showed that the clinical effective rate [RRN 1.2595 CIQ 1.101.43 P0.001] and the bacterial clearance rate [RRN 1.2595 CI 1.05T 1.48 P0.01] were significantly higher than those in the control group, while the incidence of mortality [RRR0.7495CI0.5CI0.46V1.18P0.21] and adverse reactions [RR0.81-95CI0.480.45] was significantly higher than that of the control group.The difference was not statistically significant.Conclusion: prolonged or continuous infusion of meropenem can improve the efficacy in the treatment of severe infection.Limited by the quality of methodology included in the study, this conclusion needs to be further verified by a large sample of high quality randomized controlled trials.
【作者单位】：武汉大学人民医院药学部;武汉大学人民医院新生儿科;
【分类号】：R978.1

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