[關(guān)鍵詞]
[摘要]
目的 系統(tǒng)評(píng)價(jià)中國(guó)人群使用卡貝縮宮素和縮宮素用于預(yù)防產(chǎn)后出血的安全性。方法 計(jì)算機(jī)檢索EMbase、PubMed,中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(CNKI)、維普中文科技期刊數(shù)據(jù)庫(VIP)和萬方等數(shù)據(jù)庫,收集卡貝縮宮素對(duì)比縮宮素用于預(yù)防中國(guó)人群產(chǎn)后出血安全性的隨機(jī)對(duì)照研究(RCT),檢索時(shí)限均從2000年1月—2017年12月。由2位研究者按事先設(shè)計(jì)好的納入與排除標(biāo)準(zhǔn)篩選文獻(xiàn)、提取資料、評(píng)價(jià)納入研究的偏倚風(fēng)險(xiǎn)后,采用Rev Man 5.1軟件進(jìn)行Meta-分析。結(jié)果 共納入12個(gè)RCTs,2 122例患者。Meta-分析結(jié)果顯示,卡貝縮宮素的不良反應(yīng)總發(fā)生率(OR=0.65,95%CI=0.48~0.88,P=0.005)顯著小于縮宮素;不良反應(yīng)臨床類型亞組分析顯示,卡貝縮宮素的惡心、嘔吐發(fā)生率(OR=0.51,95%CI=0.35~0.74,P=0.000 4)、心動(dòng)過速發(fā)生率(OR=0.20,95%CI=0.12~0.31,P<0.00001)和低血壓發(fā)生率(OR=0.28,95%CI=0.13~0.60,P=0.001)均顯著小于縮宮素;面部潮紅發(fā)生率(OR=0.93,95%CI=0.363~1.36,P=0.70)和頭痛、頭暈發(fā)生率(OR=0.69,95%CI=0.43~1.08,P=0.11)均無顯著性差異。結(jié)論 卡貝縮宮素能顯著降低不良反應(yīng)發(fā)生率,尤其在惡心、嘔吐,心動(dòng)過速和低血壓方面尤為顯著。
[Key word]
[Abstract]
Objective To systemically evaluate the safety of carbetocin and oxytocin for prevention of postpartum hemorrhage in Chinese patients. Methods Search was conducted in the following databases:PubMed, EMbase, CNKI, VIP and WanFang Data from January 2000 to December 2017. Randomized controlled trials (RCTs) of the safety of caebetocin vs oxytocin in prevention of postpartum hemorrhage of cesarean section in Chinese patients were included. Two reviewers independently screened literatures, extracted data, and assessed the risk of bias of included studies according to the inclusion and exclusion criteria. Meta-analysis was conducted by RevMan 5.1 software. Results A total of 12 RCTs were included with 2 122 patients. Meta-analysis showed that:the total adverse reaction rate of carbetocin (OR=0.65, 95%CI=0.48-0.88, P=0.005) was much lower than that in oxytocin; And in clinical subgroups of adverse reaction, the rate of nausea or vomiting (OR=0.51, 95%CI=0.35-0.74, P=0.000 4), the rate of tachycardia (OR=0.20, 95%CI=0.12-0.31, P<0.000 01) and the rate of hypotension (OR=0.28, 95%CI=0.13-0.60, P=0.001) were all much lower than that in oxytocin; And the rate of facial flush (OR=0.93, 95%CI=0.363-1.36, P=0.70) and the rate of headache or dizziness (OR=0.69, 95%CI=0.43-1.08, P=0.11) had no significant difference than that in oxytocin. Conclusion The results of this study show that carbetocin can significantly reduce the adverse reaction rate, especially in nausea or vomiting, tachycardia and hypotension are particularly significant.
[中圖分類號(hào)]
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