盐酸戊乙奎醚及阿托品治疗急性有机磷农药中毒效果的Meta分析  

A Meta-analysis of the Effectiveness of the Penehyclidine Hydrochloride and Atropine in Treatment of Acute Organophosphorus Pesticide Poisoning

作　　者：陈靖宜[1] 段斌[2] 刘菊英[1,3] 

机构地区：[1]武汉大学人民医院麻醉科,武汉430060 [2]湖北医药学院附属太和医院急诊科,湖北十堰442000 [3]湖北医药学院附属太和医院麻醉科,湖北十堰442000

出　　处：《临床误诊误治》2012年第5期71-74,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的评价我国文献报道的盐酸戊乙奎醚与阿托品治疗急性有机磷农药中毒(acute organophosphorus pes-ticide poisoning,AOPP)的效果及安全性。方法检索维普中文科技期刊、万方医学数据库、中国知网2000年1月～2010年12月收录的文献中有关盐酸戊乙奎醚与阿托品治疗AOPP效果的比较研究,以Peter等的文献质量评价系统对纳入文献进行质量评价,采用Rev Men 5.0软件进行Meta分析。结果共纳入6篇文献480例,试验组(采用盐酸戊乙奎醚治疗)229例,对照组(采用阿托品治疗)251例。6篇文献均为中、高质量文献,基线资料比较无显著差异。Meta分析结果显示试验组治愈率较对照组高14%[RR=1.14,95%CI(1.08,1.20),P<0.00001],平均住院时间较对照组缩短4.45 d[MD=-4.45,95%CI(-6.56,-2.35),P<0.0001],不良反应发生率较对照组降低92%[RR=0.08,95%CI(0.04,0.15),P<0.00001]。结论从现有临床证据看,盐酸戊乙奎醚治疗AOPP效果较阿托品好,但由于可供分析的样本量有限,尚需更多大宗病例的随机临床对照试验结果进一步验证。Objective To evaluate the literature of the efficacy and safety of Penehyclidine Hydrochloride and Atropine in the treatment of acute organophosphorus pesticide poisoning in China.Methods We retrieved Weipu Chinese Technology Periodicals,WanFang Medical Databanks and CNKI during January 2000 and December 2010 for comparative study on the efficacy of the Penehyclidine Hydrochloride and Atropine in the treatment of acute organophosphorus pesticide poisoning.We also used Peter literature quality assessment system to assess the literature quality.Statistical Software Rev Man 5.0 was used for Meta-analysis.Results The 6 records for indexes included 480 cases,the experimental group(Penehyclidine Hydrochloride group,n =229) and the control group(Atropine group,n = 251).6 papers of the literature were of medium or high qualtiy.There was no significant difference in baseline information.Meta-analysis showed that the recovery rate of the experimental group was higher than that of the control group [14%,RR=1.14,95% CI(1.08,1.20),P <0.00001)].The average hospital stay was 4.45 days shorter than that of the control group [MD=-4.45,95%CI(-6.56,-2.35),P < 0.0001].The incidence rate of adverse reactions decreased by 92% compared with that of the control group [RR=0.08,95% CI(0.04,0.15),P <0.00001].Conclusion Treatment of acute organophosphorus pesticide poisoning with penehyclidine Hydrochloride is better than Atropine existing clinical evidence.As the sample capacity available for analysis is limited,more cases of large randomized controlled clinical trials are needed to further validate the results of it.

关 键 词：有机磷化合物 中毒 盐酸戊乙奎醚 阿托品 META分析 

分 类 号：R595.4[医药卫生—内科学]