吗啡与氢吗啡酮在硬膜外自控镇痛的比较：meta分析  

Comparison of patient controlled epidural analgesia effect between morphine and hydromorphone:meta-analysis

作　　者：陈伟强[1] 郑春勤[2] 曹铭辉[3] CHEN Weiqiang;ZHENG Chunqin;CAO Minghui(Department of Anesthesiology,Shantou Central Hospital,Shantou 515000;Department of Gynecology and Obstetrics,Shantou Central Hospital,Shantou 515000;Department of Anesthesiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]汕头市中心医院麻醉科,广东汕头515000 [2]汕头市中心医院妇产科,广东汕头515000 [3]中山大学孙逸仙纪念医院麻醉科,广州510120

出　　处：《岭南现代临床外科》2019年第4期451-454,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省科技计划项目(20160912)

摘　　要：目的采用meta分析系统评价吗啡与氢吗啡酮硬膜外自控镇痛的有效性与安全性。方法检索PubMed、Cochrane Library万方和CNKI数据库,无语种限制,检索时限截至2019年2月。按照纳入及剔除标准收集评价吗啡与氢吗啡酮应用于硬膜外自控镇痛的临床研究,按照改良Jadad质量评估量表对纳入研究进行方法学质量的评估,采用Stata 12.0进行Meta分析。结果最终共5项研究符合纳入标准,共455例患者。与吗啡组相比,氢吗啡酮组术后皮肤瘙痒的发生率明显减少;两组术后其他不良反应及镇痛评分无明显差别。结论与吗啡相比,氢吗啡酮应用于术后硬膜外镇痛的不良反应较少。Objective To systematically evaluate thepatient controlled epidural analgesia(PCEA)effect between morphine and hydromorphone,so as to provide evidence for clinical application.MethodsDatabases including the PubMed,Cochrane Library,WanFang Data,and CNKI(by February 2019)were searched for randomized controlled trials(RCTs)involving the PCEA effect between morphine andhydromorphone in adult patients,with no language limit.According to the modified Jadad quality scale,literature was screened,data were extracted,and quality of the included studies was critically evaluated.then meta-analysis was performed using Stata 12.0 software.Results A total of 5 RCTs involving 455patients were included.The results of meta-analyses showed that:compared with patients in the morphine group,the incidence ofpruritus was lower for patients in the hydromorphone group;neither scoresof visual analog scale(VAS)for pain at rest nor VAS scores for pain with movement differed statisticallybetween the two groups.There was no significant difference in the incidence of nausea and vomiting andother side effects between the two groups.Conclusion Compared with morphine,PCEA with hydromorphone has less side effects and is worthy to recommend its clinical use.

关 键 词：氢吗啡酮 吗啡 硬膜外 镇痛 META 

分 类 号：R61[医药卫生—外科学]