佩尼希克利丁与抗药结合用于预防术后恶心和吐:随机对照试验的元分析和试验顺序分析
Hongwei Zhang1, Jianqiao Zheng2, Lu Zhang2
1Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
Medicine
|June 23, 2025
概括
佩尼希克利丁与抗药物结合,有效地预防术后恶心和吐 (PONV),减少其发生率和救援治疗的需要. 虽然口腔干燥是一种潜在的副作用,但其他抗胆性并发症并没有增加.
科学领域:
- 麻醉学和药理学 麻醉学和药理学
- 临床试验分析
- 基于证据的医学基于证据的医学.
背景情况:
- 手术后恶心和吐 (PONV) 是麻醉和手术后的常见并发症.
- PONV显著影响患者的满意度,并可能导致进一步的术后问题.
- 这项研究评估了penehyclidine与抗emetics用于PONV预防的疗效和安全性.
研究的目的:
- 为了确定基利丁与抗药物结合在预防PONV中的有效性.
- 评估这种组合治疗的安全性.
- 分析对PONV严重程度的影响以及需要救援药物的需要.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个英语和中文数据库,直到2025年1月.
- 使用Cochrane工具和GRADE评估偏差风险,并进行子组和试验顺序分析.
主要成果:
- 有1561名参与者的16个RCT显示,基利丁组合治疗减少了PONV发病率 (RR 0.65) 和24小时的严重PONV (RR 0.29).
- 观察到 postoperative 救援抗emetic 治疗的需要显著减少 (RR 0.42).
- 观察到口腔干燥的发病率增加 (RR 3.10),但其他抗胆性并发症并没有增加.
结论:
- 与抗emetics相结合的penehyclidine与单独抗emetics相比,提供了优越的PONV预防.
- 这种组合疗法导致PONV的发病率降低,PONV的发病率降低,以及减少了救援抗药的需要.
- 主要的不良影响是口腔干燥,其他抗胆固醇副作用没有显著增加.
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