低温疗法对紫杉醇化疗所致周围神经毒性预防效果的系统评价  

Systematic evaluation of the preventive effect of hypothermia on peripheral neurotoxicity induced by paclitaxel chemotherapy

作　　者：刘苗 刘玉莹 方婷婷[1] 陶珊 熊俪 吴毅 熊丹雅 LIU Miao;LIU Yuying;FANG Tingting;TAO Shan;XIONG Li;WU Yi;XIONG Danya(Department of Radiotherapy and Chemotherapy,Zhongnan Hospital of Wuhan University,Wuhan 430062,Hubei,China)

机构地区：[1]武汉大学中南医院肺部肿瘤放化疗科,湖北武汉430062

出　　处：《护士进修杂志》2024年第13期1414-1422,共9页Journal of Nurses Training

摘　　要：目的系统评价低温疗法预防紫杉醇化疗所致周围神经毒性(taxane-induced peripheral neuropathy,TIPN)的有效性和安全性。方法计算机检索The Cochrane Library、JBI、OVID、Web of Science、Embase、Medline、PubMed、中国知网、万方、维普、中国生物医学等数据库内有关于低温预防TIPN的随机或非随机对照实验,检索时间自2013年3月1日-2023年3月1日。由2名研究人员独立筛选、评价文献、提取资料,并使用RevMan5.4软件进行meta分析。结果共纳入12篇英文文献,涉及809个样本量,meta分析结果显示:低温疗法能够降低TIPN总体发病率[RR=0.45,95%CI(0.36,0.57),P<0.001],保护患者外周感觉神经[RR=0.59,95%CI(0.36,0.97),P<0.05]/[RR=0.23,95%CI(0.11,0.47),P<0.01];实验组与对照组TIPN治疗药物的使用频率[RR=0.80,95%CI(0.58,1.10),P=0.17]、紫杉醇化疗剂量减少或中断次数[RR=0.70,95%CI(0.34,1.42),P=0.32]差异无统计学意义,不良反应发生率[RR=9.80,95%CI(4.06,23.67),P=0.91]差异有统计学意义。结论低温疗法能够降低TIPN发病率,保护外周感觉神经。Objective To systematically evaluate the efficacy and safety of hypothermia therapy in the prevention of peripheral neurotoxicity(TIPN)induced by paclitaxel chemotherapy.Methods The Cochrane Library,JBI,OVID,Web of Science,Embase,Medline,PubMed,CNKI,Wanfang,VIP,Chinese Biomedical and other databases were searched by computer for RCT or nRCT trials on the prevention of TIPN by hypothermia,and literatures were searched from March 1,2013 to March 1,2023.Literature was independently screened and evaluated,the data was extracted by 2 researchers,and meta-analysis was performed using RevMan5.4 software.Results A total of 809 samples were included in 12 English literatures.The results of meta-analysis showed that hypothermia significantly reduced the overall incidence of TIPN(RR=0.45,95%CI was 0.36~0.57,P<0.001),protect the patient's peripheral sensory nerve(RR=0.59,95%CI was 0.36~0.97,P<0.05)/(RR=0.23,95%CI was 0.11~0.47,P<0.01);There was no significant difference in the frequency of TIPN treatment between the experimental group and the control group(RR=0.80,95%CI was 0.58~1.10,P=0.17)and in the reduction or interruption times of paclitaxel chemotherapy dose(RR=0.70,95%CI was 0.34~1.42,P=0.32);The incidence of adverse reactions(RR=9.80,95%CI was 4.06~23.67,P=0.91)was statistically significant.Conclusion Hypothermia can significantly reduce the incidence of TIPN and protect peripheral sensory nerves.

关 键 词：低温疗法 紫杉醇化疗 周围神经毒性 系统评价 护理 

分 类 号：R473[医药卫生—护理学] R730.53[医药卫生—临床医学]