摘要
目的 系统评价3种蛇毒血凝酶类药物用于腹部手术止血的效果及安全性,为临床用药提供循证依据。方法 计算机检索Embase、Cochrane Library、PubMed、中国生物医学文献数据库、中国知网及万方数据库,收集3种蛇毒血凝酶类药物(蛇毒血凝酶注射液、注射用矛头蝮蛇血凝酶、注射用尖吻蝮蛇血凝酶)在腹部手术的随机对照试验(RCT),检索时限均为建库至2023年8月。按纳入排除标准对文献进行筛选、质量评价及数据提取,使用Cochrane 5.1手册进行文献质量评价。采用Stata 15.1软件绘制风险偏倚图及网状图,应用R 3.6.2软件以及马尔科夫链-蒙特卡洛方法进行贝叶斯网状Meta分析。结果 共纳入11项研究,合计1 401例患者,试验组852例、对照组549例。在腹部手术止血效果方面,蛇毒血凝酶注射液明显优于注射用尖吻蝮蛇血凝酶[MD=-2.45,95%CI(-4.39,-0.24),P<0.05],减少术中出血量概率排序为蛇毒血凝酶注射液>注射用矛头蝮蛇血凝酶>注射用尖吻蝮蛇血凝酶;在安全性方面,3种蛇毒血凝酶类药物与安慰剂相比差异均无统计学意义(P>0.05)。结论 蛇毒血凝酶注射液在腹部手术中止血效果明显优于注射用尖吻蝮蛇血凝酶,3种蛇毒血凝酶类药物安全性均良好。
OBJECTIVE To systematically evaluate the hemostatic effect and safety of snake venom hemocoagulase drugs in abdominal surgery,so as to provide evidence-based evidence for clinic.METHODS Retrieved from Embase,Cochrane Library,PubMed,China Biomedical Literature Database,CNKI and Wanfang database,randomized controlled trials(RCTs)about 3 kinds of snake venom hemocoagulase drugs(Hemocoagulase injection,Hemocoagulase Bothrops atrox for injection,Haemocoagulase Agkistrodon for injection)in abdominal surgery were collected from the establishment of the database to Aug.2023.Screening,quality evaluation,and data extraction were conducted on literature according to the inclusion and exclusion criteria,and Cochrane 5.1 was used for literature quality evaluation.The risk bias diagram and network diagram were drawn by Stata 15.1 software,and the Bayesian network meta-analysis was carried out by using R 3.6.2 software and Markov chain-Monte Carlo method.RESULTS A total of 11 studies were included,involving 1401 patients,852 in the study group,and 549 in the control group.In terms of hemostatic effect,Hemocoagulase injection was significantly superior to Haemocoagulase Agkistrodon for injection[MD=-2.45,95%CI(-4.39,-0.24),P<0.05],and the probability of reducing intraoperative bleeding was ranked as follows:Hemocoagulase injection>hemocoagulase B.atrox for injection>Haemocoagulase Agkistrodon for injection;in terms of safety,there was no statistically significant difference between the three snake venom hemocoagulase drugs and placebo(P>0.05).CONCLUSIONS The hemostatic effect of Hemocoagulase injection in abdominal surgery is significantly better than that of Haemocoagulase Agkistrodon for injection;all three snake venom hemocoagulase drugs have good safety.
作者
郑子恢
潘慧杰
赵紫楠
胡欣
金鹏飞
ZHENG Zihui;PAN Huijie;ZHAO Zinan;HU Xin;JIN Pengfei(Dept.of Pharmacy,Beijing Hospital/National Center for Gerontology/Institute of Geriatrics,Chinese Academy of Medical Sciences/Beijing Key Laboratory for Clinical Risk and Individualized Application Evaluation of Drugs(Beijing Hospital),Beijing 100730,China;Dept.of Laboratory,Beijing Hospital/National Center for Gerontology/Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中国药房》
CAS
北大核心
2023年第21期2631-2637,共7页
China Pharmacy
基金
国家重点研发计划项目(No.2020YFC2008305)。
