右美托咪定在剖宫产术中预防卡前列素氨丁三醇不良反应的系统评价  

Systematic Evaluation of the Preventive Effect of Dexmedetomidine on Adverse Drug Reactions Caused by Carboprost Tromethamine During Cesarean Section

作　　者：孔令希[1] 王红梅[1] 邱峰[1] 单雪峰[1] 任萦迎 杨洋[2] KONG Lingxi;WANG Hongmei;QIU Feng;SHAN Xuefeng;REN Yingying;YANG Yang(Dept.of Pharmacy,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Dept.of VIP Anesthesiology,Jinshan Hospital,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院药学部,重庆400016 [2]重庆医科大学附属第一医院金山医院VIP部麻醉科,重庆400016

出　　处：《中国药房》2020年第15期1901-1905,共5页China Pharmacy

基　　金：重庆市科卫联合医学科研项目(No.2018ZDXM014)。

摘　　要：目的:系统性评价右美托咪定(DEX)在剖宫产术中预防卡前列素氨丁三醇不良反应的有效性,为剖宫产的临床合理用药提供循证参考。方法:计算机检索PubMed、Cochrane图书馆、Embase、中国期刊全文数据库、中国生物医学文献数据库、万方数据库和维普网,检索时限均为各数据库自建库起至2019年6月。收集DEX(试验组)对比生理盐水(对照组)预防剖宫产术中使用卡前列素氨丁三醇的不良反应的随机对照试验(RCT),对符合纳入标准的文献进行资料提取,并采用改良Jadad量表进行质量评价后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入11项RCT,合计714例患者。Meta分析结果显示,试验组患者恶心[OR=0.09,95%CI(0.06,0.14),P<0.000 01]、呕吐[OR=0.09,95%CI(0.05,0.15),P<0.000 01]、面部潮红[OR=0.15,95%CI(0.10,0.22),P<0.000 01]、胸闷[OR=0.12,95%CI(0.08,0.18),P<0.000 01]、高血压[OR=0.06,95%CI(0.04,0.11),P<0.000 01]、心动过速[OR=0.17,95%CI(0.12,0.25),P<0.000 01]等不良反应发生率均显著低于对照组,差异均有统计学意义。结论:DEX可减少剖宫产术中使用卡前列素氨丁三醇所致恶心、呕吐等不良反应。OBJECTIVE:To evaluate the preventive effect of dexmedetomidine(DEX)on adverse drug reactions induced by carboprost tromethamine used in cesarean section,and to provide evidence-based reference for rational drug use of cesarean section.METHODS:Retrieved from PubMed,Cochrane library,Embase,CNKI,CBM,Wanfang database and VIP during inception to June of 2019,randomized controlled trials about DEX(trial group) versus normal saline(control group) in the prevention of adverse drug reactions induced by carboprost tromethamine in cesarean section were collected. After data extraction of included literatures and quality evaluation with modified Jadad scale,Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS:A total of 11 RCTs with 714 patients were included in this study. Results of Meta-analysis showed that the incidence of nausea [OR=0.09,95%CI(0.06,0.14),P<0.000 01],vomiting [OR=0.09,95%CI(0.05,0.15),P<0.000 01],facial flushing [OR=0.15,95%CI(0.10,0.22),P<0.000 01],chest distress [OR=0.12,95%CI(0.08,0.18),P<0.000 01],hypertension [OR=0.06,95%CI(0.04,0.11),P<0.000 01] and tachycardia [OR=0.17,95%CI(0.12,0.25),P<0.000 01] in trial group were significantly lower than control group,with statistical significance. CONCLUSIONS:DEX can reduce adverse drug reactions such as nausea and vomiting caused by carboprost tromethamine used in cesarean section.

关 键 词：右美托咪定 剖宫产 卡前列素氨丁三醇 不良反应 META分析 系统评价 

分 类 号：R969.3[医药卫生—药理学]