氟哌啶醇预防术后恶心呕吐的Meta分析
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篇名: | 氟哌啶醇预防术后恶心呕吐的Meta分析 |
TITLE: | |
摘要: | 目的:系统评价氟哌啶醇预防术后恶心呕吐(PONV)的有效性和安全性,为临床“超说明书用药”提供循证参考。方法:计算机检索Medline (PubMed)、EMBase(Ovid)、Cochrane图书馆、Clinical trials、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据库,全面收集氟哌啶醇单用或者联合常规止吐方案对比安慰剂或阳性药物或常规止吐方案单用预防PONV的随机对照试验(RCT),提取资料并采用改良的Jadad评分标准评价文献质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入15项RCT,合计2 629例患者。Meta分析结果显示,与安慰剂比较,氟哌啶醇可以显著提高患者24 h内PONV完全控制率[RR=1.69,95%CI(1.35,2.12),P<0.001],而与昂丹司琼/托烷司琼比较差异无统计学意义[RR=1.00,95%CI(0.89,1.12),P=0.99];与单用常规止吐方案比较,氟哌啶醇联合常规止吐方案可以显著提高患者24 h内PONV完全控制率[RR=1.21,95%CI(1.06,1.39),P=0.006]和48 h内PONV完全控制率[OR=7.58,95%CI(3.59,16.02),P<0.001]。两组患者锥体外系反应发生率[RR=3.05,95%CI(0.74,12.67),P=0.12]、镇静发生率[RR=1.27,95%CI(0.73,2.20),P=0.39]和Q-T间期延长发生率[RR=1.06,95%CI(0.77,1.48),P=0.71]比较差异均无统计学意义。结论:氟哌啶醇可有效预防PONV,对24 h和48 h内PONV均有良好的控制效果,且不增加患者锥体外系反应、镇静和Q-T间期延长等不良反应的发生。 |
ABSTRACT: | OBJECTIVE: To systematically review the effectiveness and safety of haloperidol in the prevention of nausea and vomiting (PONV), and provide evidence-based reference for off-label drug use in clinic. METHODS: Retrieved from Medline (PubMed), Embase (Ovid), Cochrane Library, Clinical trials, CBM, CNKI, VIP and Wanfang Database, randomized controlled trials (RCT) about the haloperidol alone or combined with conventional antiemetic regimens versus positive drugs or placebo or conventional antiemetic regimens in the prevention of PONV were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad scale. RESULTS: Totally 15 RCTs were included, involving 2 629 patients. Results of Meta-analysis showed, compared with placebo, haloperidol can significantly improve the control rate of PONV within 24 h [RR=1.69,95%CI(1.35, 2.12),P<0.001], while compared with ondansetron/tropisetron, there was no significant difference [24 h:RR=1.00,95%CI(0.89,1.12),P=0.99]; compared with conventional antiemetic regimens, haloperidol combined with conventional antiemetic regimens can significantly improve 24 h [RR=1.21,95%CI(1.06,1.39),P=0.006] and 48 h [OR=7.58,95%CI(3.59,16.02),P<0.001] control rate of PONV. And there were no significant differences in the incidences of extrapyramidal reactions [RR=3.05,95%CI(0.74,12.67),P=0.12], sedation [RR=1.27,95%CI(0.73,2.20),P=0.39] and Q-T interval prolongation [RR=1.06,95%CI(0.77,1.48),P=0.71] in 2 groups. CONCLUSIONS: Haloperidol can effectively prevent the nausea and vomiting induced by surgeries, and shows good effects on the PONV within 24 h and 48 h, do not increase the incidences of extrapyramidal reactions, sedation and adverse reactions in Q-T interval prolongation.. |
期刊: | 2016年第27卷第36期 |
作者: | 杜朝阳,梁瑶,孙路路 |
AUTHORS: | DU Chaoyang,LIANG Yao,SUN Lulu |
关键字: | 氟哌啶醇;预防;术后恶心呕吐;Meta分析 |
KEYWORDS: | Haloperidol; Prevents; Postoperative nausea and vomiting; Meta-analysis |
阅读数: | 385 次 |
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