静脉注射地塞米松预防成人术后气道并发症的meta分析  

Meta-analysis of intravenous Dexamethasone for prevention of postoperative airway complications in adults

作　　者：李玉倩 叶建荣[1] 艾克拜尔·努尔买买提 王佳玲 李江玉 LI Yuqian;YE Jianrong;Aikebaier Nuermaimaiti;WANG Jialing;LI Jiangyu(Department of Anesthesiology,First Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院麻醉科,新疆乌鲁木齐830054

出　　处：《中国医药导报》2024年第4期91-94,111,共5页China Medical Herald

基　　金：国家自然科学基金资助项目(82060581);新疆维吾尔自治区自然科学基金资助项目(2021D01C309)。

摘　　要：目的 评价术前静脉注射地塞米松对术后气道并发症的预防作用。方法 全面检索Pub Med、Embase和Cochrane数据库,检索时间为建库至2023年6月,收集术前静脉注射地塞米松对术后气道并发症预防作用的相关随机对照试验(RCTs)。采用Stata 15.0软件进行meta分析、敏感性分析和发表偏倚评价。结果 纳入14篇RCTs进行meta分析,共涉及1 219例患者。meta分析结果显示,试验组术后24 h咽喉痛发生率低于对照组(RR=0.496,95%CI:0.403~0.610,P<0.001),术后6 h咽喉痛发生率低于对照组(RR=0.643,95%CI:0.439~0.942,P=0.033)。试验组术后24 h咳嗽(RR=0.588,95%CI:0.444~0.779,P<0.001)、声音嘶哑发生率(RR=0.504,95%CI:0.334~0.761,P=0.001)均低于对照组。两组术后24 h咽喉痛发生率比较的Begg’test检验结果显示存在发表偏倚(P<0.05),采用剪补法分析结果显示该偏倚对meta分析结果无影响。结论 术前静脉注射地塞米松能够显著降低部分术后气道并发症的发生率。Objective To evaluate the preventive effect of preoperative intravenous Dexamethasone on postoperative airway complications.Methods A comprehensive Pub Med,Embase,and Cochrane database search was conducted from the establishment of the database to June 2023 to collect relevant randomized controlled trials(RCTs) on the prevention of postoperative airway complications caused by preoperative intravenous Dexamethasone.Stata15.0 software was used for meta-analysis,sensitivity analysis and publication bias evaluation.Results A total of 14 RCTs involving 1 219 patients were included in the meta-analysis.The results of meta-analysis showed that the incidence of sore throat at 24 hours after surgery in the experimental group was lower than that in the control group(RR=0.496,95%CI:0.403-0.610,P<0.001),and the incidence of sore throat at the six hours after surgery was lower than that in the control group(RR=0.643,95%CI:0.439-0.942,P=0.033).The incidence of cough(RR=0.588,95% CI:0.444-0.779,P <0.001) and hoarseness(RR=0.504,95% CI:0.334-0.761,P=0.001) at 24 hours after surgery in the experimental group were lower than that in the control group.The Begg'test results of the comparison of the incidence of sore throat at 24 h after surgery between the two groups showed publication bias(P<0.05),and the results of shear compensation analysis showed that this bias had no effect on the results of meta-analysis.Conclusion Preoperative intravenous Dexamethasone can significantly reduce the incidence of some postoperative airway complications.

关 键 词：地塞米松 术后气道并发症 静脉注射 META分析 

分 类 号：R619[医药卫生—外科学]