摘要
目的通过Meta分析的方法研究氟比洛芬酯（FA）对手术患者凝血功能的影响。方法计算机检索Pubmed数据库、万方数据库、CNKI数据库相关文献，检索时间均为建库至2017年8月，同时手检纳入文献的参考文献，检索所有比较手术前或后有无使用FA患者的随机对照研究（RCT）或临床对照研究（CCT）。由2名评价者独立筛选文献、提取资料和方法学质量评估后，采用RevMan5．3软件对研究数据进行系统评价。结果共纳入11项临床研究，包括10项RCTs研究，1项CCT，共643例患者。Jadad评分≤3分，研究质量偏低。FA组患者凝血酶原时间、凝血酶时间、活化部分凝血活酶时间和纤维蛋白原以及血小板计数在FA用药前、用药后30rain、1～2h、6～8h、24h及48h与对照组比较，差异均无统计学意义（P〉0．05）。另外，通过收集其他凝血指标，即Sonoelot凝血指标全血激活凝固时间、凝血速率、血小板功能（PF）、凝血达到高峰时间、平均血小板体积、血小板最大聚集率、1min时的血小板聚集率（PAGl）、5min时的PAG5、最大峰值PAG，发现除有1项研究的PF在用药后术中2h较对照组降低，其余指标均无显著差异。结论FA在临床常用剂量下是安全的，对患者凝血功能不产生显著影响。
Objective To analyze the effect of flurbiprofen axetil （FA） on blood coagulation in patients undergoing surgery through systematic review and meta-analysis. Methods PubMed, WanFang and CNKI databases were searched from their establishment to August 2017 by computer retrieval for relevant literature on the blood coagulation effect of FA. The references of the studies included were also searched by hand. Two reviewers independently screened the literature, extracted data from full-text articles, and evalu-ated the methodological quality of included studies. All data were analyzed by Review Manager 5.3. Re-sults Altogether 11 studies were finally included, consisting of 10 RCTs and one case-control study, involving 643 patients undergoing surgery. The mean Jadad score for all the studies included were less than 3, suggesting low methodological quality of the studies included. The pool analysis of 4 blood coagulation indexes （prothrombin time, thrombin time, activated partial thromboplastin time and fibrinogen） and platelet count showed that there were no significant differences between the control group and flurbiprofen axetil group before treatment and at 30 min, 1-2 h, 6-8 h, 12 h, 24 h and 48 h after treatment（P 〉 0.05）. As for other out- comes like Sonoelot coagulation indexes [activated clotting time of whole blood, coagulation rate and platelet function （PF） ], time to peak, mean platelet volume, maximum platelet aggregation rate, platelet aggregation rate at 1 min （PAG1）, platelet aggregation rate at 5 min （PAG5） and platelet aggregation rate maximum, no significant differences were found except in one study where PF was found to be lower at 2 h after treatment in the FA group than in the control group. Conclusion Use of FA in common clinical doses is safe for postoperative analgesia, because blood coagulation may not be siguifieantly affected.
作者
王卫国
郭万首
Wang Weiguo;Guo Wanshou(Department of Orthopaedics,China Japan Friendship Hospital,Beijing 100029,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2018年第10期889-896,共8页
Chinese Journal of Orthopaedic Trauma
关键词
系统评价
镇痛
手术后期间
氟比洛芬酯
凝血功能
Systematic review
Analgesia
Posoperative period
Flurbiprofen axetil
Blood coagulation
