围手术期抗血小板药物对玻璃体切割术安全性影响的Meta分析  

Effects of perioperative antiplatelet agents on the safety of vitrectomy:A Metaanalysis

作　　者：邓宇 王建伟[1] 张玮琼 王晶莹 接传红[1] DENG Yu;WANG Jianwei;ZHANG Weiqiong;WANG Jingying;JIE Chuanhong(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中国中医眼科杂志》2022年第5期416-420,共5页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金(81874494)。

摘　　要：目的系统评价围手术期抗血小板治疗对玻璃体切割术(PPV)手术安全性的影响。方法计算机检索PubMed、EMbase和Cochrane Central数据库中围手术期使用阿司匹林、氯吡格雷对PPV安全性影响的队列研究,检索时间为2010年1月—2021年1月。由2名研究人员分别进行文献筛选和数据提取,并评价纳入研究的偏倚风险,用Stata 16软件和RevMan 5.3软件进行Meta分析。结果总共纳入7篇队列研究,共计2,758例患者(2,758只眼),其中抗血小板治疗组631例,对照组2,127例。Meta分析显示,研究结果不存在异质性(I2=15%);采用固定效应模型分析,结果显示2组差异无统计学意义[RR=1.15,95%CI(0.89,1.49),P=0.310]。结论PPV围手术期使用阿司匹林和氯吡格雷对患者围手术期玻璃体积血无明显影响。建议长期服用抗血小板药物的患者,在PPV围手术期可以继续使用抗血小板药物。OBJECTIVE To evaluate the effect of perioperative antiplatelet therapy on the safety of vitrectomy.METHODS PubMed,EMbase and Cochrane Central databases were searched for cohort studies on the effects of perioperative aspirin and clopidogrel on the safety of vitrectomy from January 2010 to January 2021.Literature screening and data extraction were conducted by two researchers respectively,and the risk of bias was evaluated for the included studies.Meta-analysis was performed using Stata 16 software and RevMan 5.3 software.RESULTS A total of 2,758 patients(2,758 eyes)were included from 7 cohort studies,including 631 patients in the antiplatelet treatment group and 2,127 patients in the control group.Metaanalysis showed that there was no heterogeneity(I2=15%),and no significant difference between the two groups[RR=1.15,95%CI(0.89,1.49),P=0.310].CONCLUSIONS The use of aspirin and clopidogrel during perioperative period of vitrectomy has no significant effect on perioperative vitreous hemorrhage.It is recommended that patients who take antiplatelet drugs for a long time can continue to use antiplatelet drugs during the perioperative period of vitrectomy.

关 键 词：阿司匹林 氯吡格雷 玻璃体切割术 眼内手术 围手术期出血 

分 类 号：R776.4[医药卫生—眼科]