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中国临床研究英文版:2020,33(6):727-732
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鞘内注射阿片类药物对剖宫产寒颤的预防作用的Meta分析
(1.西南医科大学中西医结合学院,四川 泸州 646000;2.西南医科大学附属中医医院麻醉科,四川 泸州 646000)
Meta-analysis of the preventive effect of intrathecal opioids on the shiver of cesarean section
摘要
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Received:July 30, 2019   Published Online:June 20, 2020
中文摘要: 目的 系统评价鞘内注射阿片类药物预防产妇剖宫产术中及术后寒颤的影响。方法 计算机检索Embase、PubMed、CINAHL、the Cochrane Library、万方、中国知网、维普以及CBM等中英文数据库,搜集鞘内注射阿片类药物对剖宫产手术患者围术期寒颤发生率影响的随机对照研究(RCT),所有数据库文献检索时限均为建库至2018年6月。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用 RevMan 5.3 进行统计分析。结果 共纳入18个RCT,包括1 428例患者。Meta分析结果显示:舒芬太尼鞘内注射组寒颤发生率明显低于对照组[OR=0.25,95%CI(0.18,0.35),P<0.01];芬太尼鞘内注射组寒颤发生率同样明显低于对照组[OR=0.25,95%CI(0.17,0.37),P<0.01]。结论 鞘内注射芬太尼或舒芬太尼可降低剖宫产手术寒颤的发生率。受纳入研究数量和质量的限制,上述结论尚需开展更多高质量研究予以验证。
Abstract:Objecitve To evaluate the effect of intrathecal injection of opioids on the prevention of shivering during and after cesarean section. Methods The databases of EMBASE, PubMed, CINAHL, the Cochrane Library, WanFangData, CNKI, VIP and CBM were searched by computer to collect a randomized controlled trail (RCT) on the influence of intrathecal opioid injection on the incidence of perioperative shivering in patients undergoing cesarean section.The retrieval time limit of all databases was from the establishment to June 2018. Two evaluators independently selected literature, extracted data and evaluated the risk of bias included in the study. Revman 5.3 was used for statistical analysis. Results A total of 18 RCT were included, including 1 428 patients.Meta-analysis showed that the incidence of shivering in sufentanil intrathecal injection group was significantly lower than that in the control group [OR =0.25, 95%CI (0.18, 0.35), P<0.01]; the incidence of shivering in fentanyl intrathecal injection group was also significantly lower than that in the control group[OR =0.25, 95%CI (0.17, 0.37), P<0.01]. Conclusion Intrathecal injection of fentanyl or sufentanil can reduce the incidence of shivering during cesarean section.Due to the limitation of the quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusions.
文章编号:     中图分类号:    文献标志码:A
基金项目:四川省卫生计生委科研课题(17PJ220)
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