摘要
目的系统评价帕瑞昔布钠用于妇科手术及术后镇痛的有效性和安全性,旨在为临床用药提供循证参考。方法计算机检索PubMed、Embase、Cochrane图书馆、中国知网、维普网、万方数据、中国生物医学文献服务系统,检索时限均为各数据库建库起至2021年2月16日。收集帕瑞昔布钠(试验组)对比0.9%氯化钠注射液(对照组)用于妇科手术及术后镇痛的随机对照试验(RCT)。筛选文献、提取资料并采用改良Jadad量表对纳入文献质量进行评价后,采用RevMan 5.3软件进行Meta分析、敏感性分析和发表偏倚分析。结果共纳入14项RCT,合计1120例患者。Meta分析结果显示,试验组患者术后4 h时的视觉模拟量表(VAS)评分[MD=-1.65,95%CI(-2.48,-0.82),P=0.0001]、术后6 h时的VAS评分[MD=-1.03,95%CI(-1.60,-0.45),P=0.0005]、术后12 h时的VAS评分[MD=-0.98,95%CI(-1.38,-0.59),P<0.00001]、术后有镇痛需求的患者比例[OR=0.14,95%CI(0.04,0.50),P=0.003]、吗啡使用剂量[MD=-17.75,95%CI(-20.93,-14.56),P<0.00001]均显著低于对照组,而两组患者的恶心发生率比较差异无统计学意义[OR=0.68,95%CI(0.43,1.08),P=0.10]。敏感性分析结果显示,上述结果基本稳定。发表偏倚分析结果显示,本研究存在发表偏倚的可能性较小。结论帕瑞昔布钠用于妇科手术及术后镇痛的疗效和安全性均较好。
OBJECTIVE To systematically evaluate the effectiveness and safety of parecoxib sodium for gynecological surgery postoperative analgesia,and to provide evidence-based reference for clinical drug use.METHODS Retrieved from PubMed,Embase,the Cochrane Library,CNKI,VIP,Wanfang data and SinoMed during the inception to Feb.16th,2021,randomized controlled trials(RCT)about parecoxib sodium(trial group)versus 0.9%sodium chloride injection(control group)for gynecological surgery and postoperative analgesia were collected.After screening literatures,extracting data and evaluating the quality of literatures with modified Jadad scale,Meta-analysis,sensitivity analysis and publication bias analysis were performed by using RevMan 5.3 software.RESULTS A total of 14 RCT were included,involving 1120 patients.The results of Meta-analysis showed that visual analogue scale(VAS)score at 4 h after operation[MD=-1.65,95%CI(-2.48,-0.82),P=0.0001],VAS score at 6 h after operation[MD=-1.03,95%CI(-1.60,-0.45),P=0.0005],VAS score at 12 h after operation[MD=-0.98,95%CI(-1.38,-0.59),P<0.00001],the proportion of postoperative analgesia requirements[OR=0.14,95%CI(0.04,0.50),P=0.003]and the dosage of morphine[MD=-17.75,95%CI(-20.93,-14.56),P<0.00001]in trial group were significantly lower than control group.There was no statistical significance in the incidence of nausea between 2 groups[OR=0.68,95%CI(0.43,1.08),P=0.10].The results of sensitivity analysis showed that the above results were basically stable.The results of publication bias analysis showed that there was little possibility of publication bias in this study.CONCLUSIONS Parecoxib sodium is effective and safe for gynecological surgery and postoperative analgesia.
作者
张欣
邓琳琳
赵慧欣
张朝甲
徐国亭
ZHANG Xin;DENG Linlin;ZHAO Huixin;ZHANG Chaojia;XU Guoting(Dept.of Rehabilitation Medicine,Nanyang Medical College,Henan Nanyang 473000,China;Teaching and Research Section of Obstetrics and Gynecology,Nanyang Medical College,Henan Nanyang 473000,China;Dept.of Obstetrics and Gynecology,Nanyang Hospital of TCM,Henan Nanyang 473000,China;Dept.of Nephrology,the First Affiliated Hospital of Nanyang Medical College,Henan Nanyang 473000,China;Dept.of Anesthesiology,the First Affiliated Hospital of Nanyang Medical College,Henan Nanyang 473000,China)
出处
《中国药房》
CAS
北大核心
2022年第10期1258-1262,1268,共6页
China Pharmacy
基金
河南省高等学校专业综合改革试点项目(No.教高[2017]23号-147)
南阳市科技发展计划项目(No.JCQY2018002)。
关键词
帕瑞昔布钠
妇科手术
术后镇痛
有效性
安全性
META分析
parecoxib sodium
gynecological surgery
postoperative analgesia
effectiveness
safety
Meta-analysis
