评估毒素在治疗老年人膀过活性的有效性和安全性:对随机对照试验的试验顺序分析的元分析与试验分析
Yu-Hsuan Chen1, Jen-Hao Kuo1, Yen-Ta Huang2
1Education Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Toxins
|November 26, 2024
概括
毒素A型 (BoNT-A) 注射有效地减少过度活动膀 (OAB) 的老年患者尿失禁的发作. 然而,这种治疗增加了高后残留和尿路感染的风险,需要仔细监测.
科学领域:
- 老年学是一门学科.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 药理学 药理学是指药理学的学科.
背景情况:
- 过度活跃的膀 (OAB) 显著影响老年人的生活质量.
- 毒素A类型 (BoNT-A) 的毒素注射是公认的OAB治疗方法,但它们在老年人中的特定疗效和安全性需要进一步研究.
研究的目的:
- 在被诊断患有OAB的老年患者中,系统地审查和元分析内突变剂BoNT-A注射的疗效和安全性.
主要方法:
- 在主要数据库 (PubMed,Embase,Cochrane图书馆,Scopus,CINAHL) 进行了全面的文献搜索,截至2024年5月30日.
- 四个随机对照试验 (RCT) 涉及803名参与者被纳入了元分析.
- 评估的主要结果是每日尿失禁 (UI) 事件的减少和患者报告的结果;次要结果集中在不良事件上.
主要成果:
- 在4-6周 (MD: -3.82) 和12周 (MD: -2.17) 时,BoNT-A注射显示每日UI发作显著减少.
- 治疗与增加空虚后残留 (RD:0.154) 和尿路感染 (RD:0.111) 的风险有关.
- 在导管治疗的必要性或出血的发生率方面没有发现显著差异.
结论:
- 在老年人群中,内突变体BoNT-A注射是管理OAB的有效治疗方法.
- 医生应谨慎行事,并实施注射后的警监测,因为已确定存在高余和尿路感染的风险.
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