帕瑞昔布钠用于妇科手术及术后镇痛有效性和安全性的Meta分析
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篇名: 帕瑞昔布钠用于妇科手术及术后镇痛有效性和安全性的Meta分析
TITLE: Meta-analysis of the effectiveness and safety of parecoxib sodium for gynecological surgery and postoperative analgesia
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RevMan5.3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4h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6h时的VAS评分[MD=-1.03,95%CI(-1.60,-0.45),P=0.0005]、术后12h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。
ABSTRACT: OBJ ECTIVE To systematically evaluate the effectiveness and s afety 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 1 120 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=0.000 1],VAS score at 6 h after operation [MD =-1.03,95%CI(-1.60,-0.45),P=0.000 5],VAS score at 12 h after operation [MD =-0.98, 95%CI(-1.38, -0.59),P<0.000 01],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, com 95%CI(-20.93,-14.56),P<0.000 01] 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 posto perative analgesia.
期刊: 2022年第33卷第10期
作者: 张欣,邓琳琳,赵慧欣,张朝甲,徐国亭
AUTHORS: ZHANG Xin,DENG Linlin,ZHAO Huixin ,ZHANG Chaojia ,XU Guoting
关键字: 帕瑞昔布钠;妇科手术;术后镇痛;有效性;安全性;Meta分析
KEYWORDS: parecoxib sodium ;gynecological surgery ;postoperative analgesia ;effectiveness;safety;Meta-analysis
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