地佐辛和芬太尼分别复合丙泊酚用于无痛人工流产术临床效果的Meta分析  

Meta analysis of clinical effect of Dezocine or Fentanil with Propofol anesthesia in painless induced abortion

作　　者：散小虎[1] 杨进国[1] 朱辉[1] 张在斌[1] 

机构地区：[1]湖北医药学院附属东风医院麻醉科,湖北十堰442000

出　　处：《中国医药导报》2015年第31期123-127,134,共6页China Medical Herald

摘　　要：目的采用系统评价地佐辛和芬太尼分别复合丙泊酚用于无痛人流术的效果和安全性。方法电子检索Cochrane图书馆、Pubmed、中国知网、万方数据库、维普资讯网中从建库到2015年1月发表的关于地佐辛和芬太尼分别复合丙泊酚用于无痛人流的随机对照试验,根据Cochrane系统评价的方法评价纳入研究的质量和提取资料,采用Rev Man 5.2软件进行统计分析。结果共纳入15篇临床随机对照试验共计1262例患者。分析结果显示:1有效性:与芬太尼复合丙泊酚组比较,地佐辛复合组能够显著减少丙泊酚的总用量(MD=-29.36,95%CI-41.60^-17.12,P=0.0100),缩短术后苏醒时间(MD=-1.62,95%CI-2.06^-1.18,P<0.0001);2不良反应:术后地佐辛复合丙泊酚组恶心呕吐、呼吸抑制、头晕的发生率均低于芬太尼组复合丙泊酚组,差异有统计学意义(OR=0.28、0.20、0.43,95%CI分别为0.17~0.46、0.13~0.31、0.26~0.73),术中体动的发生率两组比较,差异无统计学意义(OR=0.64,95%CI 0.40~1.04,P=0.07)。结论现有临床证据表明,地佐辛复合丙泊酚与芬太尼复合丙泊酚用于无痛人流术相比,可以缩短苏醒时间,减少丙泊酚的总用量及不良反应的发生,其效果更好、安全性更高。Objective To systematically evaluate the safty and effect of Dezocine or Fentanil with Propofol anesthesia for painless induced abortion. Methods A search about randomized controlled trial of Dezocine or Fentanil with Propofol anesthesia for painless induced abortion was performed within Cochrane library,Pubmed,CINK,Wanfang Data,VIP from creating database to January 2015. The data were evaluated strictly and the extracted data were analyzed by Rev Man 5.2. Results 15 randomized controlled trials involving 1262 patients were included. The results of analyses showed that： 1 Efficacy： compared with Fentani with Propofol group,the total dosage of Propofol in Dezocine with Propofol group significantly decreased（MD =-29.36,95% CI-41.60 to-17.12,P = 0.0100）,the recovery time of patients were significantly shorter（MD =-1.62,95% CI-2.06 to-1.18,P 〈0.0001）. 2 Adverse reaction： after the surgery,the incidence of nausea and vomiting,breath depress,dizziness in Dezocine with Propofol group were lower than those in Fentani with Propofol group（OR = 0.28,0.20,0.43,95%CI were 0.17-0.46,0.13-0.31,0.26-0.73）,but there was no significant difference between the two groups in patients＇ body response caused by operating stimulation（OR =0.64,95% CI 0.40- 1.04,P = 0.07）. Conclusion The limited current evidence shows that Dezocine is effective alternative to Fentanyl when administered during induced abortion operation,and Dezocine is associated with a shorter anesthesia recovery time,a lower dosage of Propofol and a lower incidence of postoperative adverse reaction compared with Fentanyl.

关 键 词：地佐辛 芬太尼 人工流产术 随机对照试验 META分析 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]