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右美托咪定用于功能性鼻内镜手术术中控制性降压有效性和安全性的Meta分析
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| 篇名： | 右美托咪定用于功能性鼻内镜手术术中控制性降压有效性和安全性的Meta分析 |
| TITLE： | Effectiveness and Safety of Dexmedetomidine for Controlled Hypotension during Functional Nasal Endoscopic Surgery：A Meta-analysis |
| 摘要： | 目的：系统评价右美托咪定对比其他控制性降压药用于功能性鼻内镜手术术中控制性降压的有效性和安全性，为其临床应用提供循证参考。方法：计算机检索PubMed、EBSCO、Springer、Ovid、Cochrane图书馆、中国期刊全文数据库、中文科技期刊数据库、万方数据库获取相关文献，同时手工检索相关专业杂志并追溯纳入文献的参考文献，收集右美托咪定（试验组）对比其他控制性降压药物（对照组）用于鼻内镜手术术中控制性降压的有效性和安全性的随机对照试验（RCT）。对符合标准的文献进行资料提取，并采用改良Jadad质量记分法评价纳入文献的方法学质量后，采用RevMan5.3统计学软件进行Meta分析。结果：共纳入8项RCT，合计497例患者。Meta分析结果显示，与对照组比较，试验组降压药补充患者数比例[OR＝0.37，95％CI（0.21，0.65），P＝0.0006]和术中出血量[MD＝－77.74，95％CI（－99.52，－55.96），P＜0.001]更少，拔管时平均动脉压[MD＝－13.40，95％CI（－16.24，－10.56），P＜0.001]和拔管时心率[MD＝－30.13，95％CI（－33.40，－26.87），P＜0.001]等血流动力学更稳定，Fromme术野质量评分更低[MD＝－0.80，95％CI（－0.96，－0.65），P＜0.001]，寒颤[OR＝0.37，95％CI（0.18，0.75），P＝0.006]和恶心呕吐[OR＝0.28，95％CI（0.14，0.59），P＝0.008]等不良反应发生率更低。结论：右美托咪定在鼻内镜手术术中控制性降压的效果和安全性具有一定优势。 |
| ABSTRACT： | OBJECTIVE：To systematically evaluate the effectiveness and safety of dexmedetomidine versus other controlled hypotension drugs for functional nasal endoscopic surgery ，and to provide evidence-based reference for clinic. METHODS ： Retrieved from PubMed ，EBSCO，Springer，Ovid，Cochrane library ，CJFD，VIP，Wanfang database ，relevant journals and references of the included literature were also searched manually. RCTs about the effectiveness and safety of dexmedetomidine （trial group）versus other controlled hypotension drugs （control group ）for functional nasal endoscopic surgery were collected. After data extraction of included literatures ，quality evaluation with modified Jada quality scoring method ，Meta-analysis was performed by using Rev Man 5.3 software. RERULTS ：A total of 8 RCTs involving 497 patients were included. Meta-analysis results showed that compared with control group ，the ratio patients of hypotensive drug supplement [OR ＝－0.37，95％CI（0.21，0.65），P＝0.000 6] and the bleeding volume [MD ＝－77.74，95％CI（－99.52，－55.96），P＜0.001] of trial groups were lower ；hemodynamics such as MAP during extubation [MD ＝－13.40，95％CI（－16.24，－10.56），P＜0.001] and heart rate during extubation [MD ＝－33.13， 95％CI（－33.40，－26.87），P＜0.001] was more stable during extubation ；quality score of Fromme surgical field was higher [MD ＝ －0.80，95％CI（－0.96，－0.65），P＜0.001]；while the incidence of chill [OR ＝0.37，95％CI（0.18，0.75），P＝0.006]，nausea and vomit [OR ＝0.28，95％CI（0.14，0.59），P＝0.008] were lower. CONCLUSIONS ：Dexmedetomidine has a certain advantage than routine drugs for controlled hypotension during nasal endoscopic surgery ，and with better safety. |
| 期刊： | 2020年第31卷第05期 |
| 作者： | 王丽，孙文冲，裴凌 |
| AUTHORS： | WANG Li，SUN Wenchong，PEI Ling |
| 关键字： | 右美托咪定；控制性降压；功能性鼻内镜手术；Meta分析 |
| KEYWORDS： | Dexmedetomidine；Controlled hypotension ；Functional nasal endoscopic surgery ；Meta-analysis |
| 阅读数： | 225 次 |
| 本月下载数： | 8 次 |
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