静脉应用糖皮质激素改善膝关节置换术后PONV和疼痛的meta分析
| 作者: |
1俞磊,
2张成欢,
1包倪荣,
1赵建宁
1 解放军南京军区南京总医院，解放军第二军医大学南京临床医学院骨科，南京 210002 2 南京中医药大学护理学院，南京 210046 |
| 通讯: |
俞磊
Email: 359302859@qq.com 张成欢 Email: zch2980799@163.com 包倪荣 Email: bnrbnr@sina.com 赵建宁 Email: zhaojianning.0207@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.11.026 |
| 基金: | 江苏省临床医学科技专项资助, BL2012002 南京市科研课题, 201402007 |
摘要
目的：通过meta分析评价静脉应用糖皮质激素改善膝关节置换术后恶心、呕吐(postoperat i venausea and vomiting，PONV)和疼痛的效果。方法：通过检索Pubmed、Cochrane图书馆、EMBAS数据库及万方数据库，搜索静脉应用激素改善膝关节表面置换术后恶心、呕吐和疼痛的随机对照研究，并追查已纳入文献的参考文献。所得数据通过Rev Man 5.1统计软件完成meta分析，比较实验组与对照组术后恶心呕吐和疼痛的改善。结果：共纳入了5篇文献中的461例膝关节置换患者。Meta分析结果显示，术后24 h实验组的效果优于空白组，PONV的OR及95%CI为0.31(0.18~0.46)，疼痛VAS(视觉模拟评分)的WMD及95%C1为−13.25(−21.64~−4.76)。结论：静脉应用糖皮质激素能够明显改善膝关节置换PONV和疼痛，并不增加术后感染发生，可以推广使用。
关键词：
膝关节置换术
PONV
糖皮质激素
meta分析
Steroids reduces postoperative nausea and vomiting and pain following TKA meta-analysis
CorrespondingAuthor: YU Lei Email: 359302859@qq.com
DOI: 10.3978/j.issn.2095-6959.2015.11.026
Abstract
Objective: To determine whether perioperative steroids reduce postoperative nausea and vomiting (PONV) and pain in the patients after total knee arthroplasty (TKA). Methods: We searched the randomized control trials (RCTs) of perioperative steroids reduce PONV and pain after TKA from Pubmed database, Cochrane library, EMBAS database, Wanfang Database and reference lists of relevant studies. The extracted data were analyzed by the Review Manager 5.1 for comparing the effect between control and placebo. Results: 5 RCTs with 461 patients were eligible for meta-analysis. Meta-analysis demonstrates that the pain level and PONV experienced in the first day of control is superior to placebo, OR and 95% CI of PONV is 0.31 (0.18~0.46), WMD and 95% CI of pain VAS is −13.25(−21.64~−4.76). Conclusion: Perioperative steroids reduces pain, PONV in patients undergoing TKA, and don’t influence wound healing.