蛇毒类血凝酶在外科手术中止血效果的网状meta分析  

Network meta-analysis of hemostatic effects of hemocoagulase in surgery

作　　者：郑子恢[1] 潘慧杰[2] 张伟伟 胡欣[1] 金鹏飞[1] 张亚同[1] ZHENG Zi-hui;PAN Hui-jie;ZHANG Wei-wei;HU Xin;JIN Peng-fei;ZHANG Ya-tong(Department of Pharmacy,Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application(Beijing Hospital),Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Clinical Laboratory,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Rehabilitation Pharmacy Center,Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100144,China)

机构地区：[1]北京医院药学部、北京市药物临床风险与个体化应用评价重点实验室(北京医院),北京100730 [2]北京医院检验科、国家老年医学中心中国医学科学院老年医学研究院,北京100730 [3]首都医科大学附属北京康复医院康复药学中心,北京100144

出　　处：《临床药物治疗杂志》2023年第10期46-51,共6页Clinical Medication Journal

基　　金：国家重点研发计划(2020YFC2009001)。

摘　　要：目的评价蛇毒类血凝酶在外科手术中的止血效果,为临床提供循证依据。方法计算机检索Embase、the Cochrane Library、PubMed、中国生物医学文献数据库、中国期刊全文数据库及万方数据知识服务平台,收集蛇毒类血凝酶在外科手术中止血的RCTs,检索时限均为建库至2023年4月。使用Cochrane方法进行文献质量评价,采用Stata 15.1软件绘制风险偏倚图及网状图,应用R 3.6.2软件的gemtc软件包进行网状meta分析。结果共纳入15项研究,1798例患者,观察组1052例,对照组746例,4种蛇毒类血凝酶在外科手术中的止血效果,虽略有不同,但差异无统计学意义(P>0.05)。减少单位面积出血量概率排序为白眉蛇毒血凝酶>尖吻蝮蛇血凝酶>矛头蝮蛇血凝酶>蛇毒血凝酶;缩短止血时间概率排序为:白眉蛇毒血凝酶>尖吻蝮蛇血凝酶>蛇毒血凝酶>矛头蝮蛇血凝酶。结论4种蛇毒类血凝酶在外科手术中的止血效果基本一致,差异未见统计学意义。Objective To systematically review the differences of the hemostatic effects of hemocoagulase in surgical operations,so as to provide evidence-based drug use for clinic.Methods Embase,the Cochrane Library,PubMed,China Biomedical Literature Database,CNKI,Wanfang Database were searched to collect RCTs of various snake venom hemocoagulase products in surgical hemostasis.The search time was from the establishment of the database to April 2023.The Cochrane was used to evaluate the quality of the literature.Stata 15.1 software was used to draw the risk of bias graghand the network diagram,and Bayesian network meta-analysis was performed using gemtc software package of R 3.6.2 software.Results A total of 15 studies were included,with 1798 patients,1052 in the observation group and 746 in the control group.The four types of snake venom hemocoagulases showed slight differences in surgical hemostasis,but the differences were not statistically significant(P>0.05).The probability of reducing the amount of bleeding per unit area was ranked as follows:hemocoagulase agkistrodon halys(HAH)>haemocoagulase agkistrodon(HCA)>hemocoagulase bothrops atrox(HBA)>hemocoagulase(H).The order of probability of shortening the hemostatic time was:HAH>HCA>H>HBA.Conclusion There is no statistical difference in the hemostatic effect of the four types of snake venom hemocoagulases.

关 键 词：蛇毒类血凝酶 外科手术 网状meta分析 

分 类 号：R973.1[医药卫生—药品]