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预防性α阻塞剂未能在骨科手术后预防术后尿:来自对比研究的元分析和试验顺序分析的证据
Lianliang Shan1, Ping Sun1, Wenping Zhang1
1Department of Hand Surgery/Foot and Ankle Surgery, Shengli Oilfield Central Hospital, Dongying, Shandong, China.
Frontiers in pharmacology
|September 11, 2023
概括
阿尔法阻塞剂不能防止骨科手术患者的术后尿. 这些药物增加了并发症的风险,这表明它们不应该用于此目的的预防.
科学领域:
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 手术后尿 (POUR) 是骨科手术后的一个常见并发症.
- 阿尔法阻断剂有时被认为可以预防POUR,但它们在这种情况下的疗效和安全性需要评估.
研究的目的:
- 系统地审查和元分析阿尔法阻断剂对骨科患者POUR的预防作用.
- 评估阿尔法阻断剂在这个患者群体中的安全性.
主要方法:
- 在PubMed,Embase,Web of Science和Cochrane图书馆数据库中进行了系统的搜索 (1990-2023年).
- 七项涉及1607名患者的研究被纳入了分析.
- 使用随机效应模型计算风险比率 (RRs),进行子组分析和试验顺序分析 (TSA).
主要成果:
- 在阿尔法阻断剂使用者 (16.8%) 和对照组 (19.6%) (RR=0.75,p=0.130) 之间没有发现POUR率的显著差异.
- 对关节塑造和脊椎手术的亚组分析也显示没有显著的预防作用.
- 阿尔法阻断剂的使用与明显更高的并发症风险有关 (RR=1.73,p=0.0005).
结论:
- 预防性α阻塞剂不会降低骨科手术后尿的风险.
- 在这种情况下使用α阻塞剂与不良事件的风险增加有关.
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