雷莫司琼与昂丹司琼预防成人术后恶心呕吐的Meta分析

doi:10.3877/cma.j.issn.2095-6568.2017.03.005

目的

用Meta分析来比较雷莫司琼与昂丹司琼在预防成人术后恶心呕吐的临床效果。

方法

通过检索Pubmed、Web of science、Cochrane Library、Google scholar等数据库，搜集比较雷莫司琼与昂丹司琼预防成人术后恶心呕吐效果的随机对照实验研究，应用R统计软件(R-3.1.3)对数据进行分析。

结果

经过评价和筛选，纳入12篇随机对照研究。Meta分析结果显示：与昂丹司琼比较，雷莫司琼具有更有效的预防术后恶心呕吐的作用，并且差异有统计学意义。

结论

就目前已有的文献来看，雷莫司琼预防术后恶心呕吐的作用由于昂丹司琼。

关键词: 雷莫司琼, 昂丹司琼, 术后恶心呕吐, Meta分析

Objective

The aim of this study was to systematicallyand objectively compare the anti-emetic effects of ramosetron and ondansetron on postoperative nausea and vomiting.

Methods

A systematic literature search of MEDLINE, Web of Science, Cochrane Library and the Google scholar were performed to recruit studies compared ramosetron and ondansetron in the treatment of postoperative nausea and vomiting.A Meta-analysis(R-3.1.3) was conducted to estimate the effect of different interventions.

Results

A total of 12 randomized controlled trails met the inclusion criteria.The study demonstrates that ramosetron is more effective than ondansetron for the prevention of postoperative nausea and vomiting.

Conclusions

Use of ramosetron is a more effective mean for reducing postoperative nausea and vomiting than ondansetron.

Key words: Ramosetron, Ondansetron, Postoperative nausea and vomiting, Meta-analysis

表1 纳入研究的基本信息

纳入研究	JADAD评分	干预	人数	患者一般信息		手术类型	手术时间(min)	数据采集的时间(h)
纳入研究	JADAD评分	干预	人数	年龄(Y)	体质量(kg)	手术类型	手术时间(min)	数据采集的时间(h)
Phillips and Hutchinson	B	G	40	35	67	腹腔镜	25	24
?	?	P	40	31	66	?	25	?
Pongprojpaw and Chiamchanya	B	G	40	32	53	腹腔镜	72	0，4，24
?	?	P	40	34	52	?	70	?
Eberhart et al.	A	G	57	57	N	腹腔镜	34	0，3，6，24
?	?	P	59	59	N	?	34	?
Nanthakomon et al.	A	G	60	41	58	开腹	127	0，2，6，12，24
?	?	P	60	41	54	?	128	?
Kalava et al.	A	G	116	33	N	剖宫产	45	2，2.5，24
?	?	P	123	33	N	?	45	?
Janngam et al.	A	G	54	37	61	四肢手术	100	0，6，24
?	?	P	54	35	61	?	?	?
Bone et al.	B	G	20	40	63	混合	58	0，2，12，24
?	?	P	20	46	61	?	52	?
Visalyaputra et al.	B	G	27	32	51	腹腔镜	20	24
?	?	P	28	33	51	?	41	?

表1 纳入研究的基本信息

纳入研究	JADAD评分	干预	人数	患者一般信息		手术类型	手术时间(min)	数据采集的时间(h)
纳入研究	JADAD评分	干预	人数	年龄(Y)	体质量(kg)	手术类型	手术时间(min)	数据采集的时间(h)
Phillips and Hutchinson	B	G	40	35	67	腹腔镜	25	24
?	?	P	40	31	66	?	25	?
Pongprojpaw and Chiamchanya	B	G	40	32	53	腹腔镜	72	0，4，24
?	?	P	40	34	52	?	70	?
Eberhart et al.	A	G	57	57	N	腹腔镜	34	0，3，6，24
?	?	P	59	59	N	?	34	?
Nanthakomon et al.	A	G	60	41	58	开腹	127	0，2，6，12，24
?	?	P	60	41	54	?	128	?
Kalava et al.	A	G	116	33	N	剖宫产	45	2，2.5，24
?	?	P	123	33	N	?	45	?
Janngam et al.	A	G	54	37	61	四肢手术	100	0，6，24
?	?	P	54	35	61	?	?	?
Bone et al.	B	G	20	40	63	混合	58	0，2，12，24
?	?	P	20	46	61	?	52	?
Visalyaputra et al.	B	G	27	32	51	腹腔镜	20	24
?	?	P	28	33	51	?	41	?

表2 纳入研究的实验结果

纳入研究	术后呕吐(POV)		术后恶心呕吐(PONV)
Phillips and Hutchinson	4/40	9/40	19/40	25/40
Pongprojpaw and Chiamchanya	7/40	12/40	12/40	23/40
Eberhart et al.	23/57	16/59	30/57	29/59
Nanthakomon et al.	17/60	28/60	29/60	40/60
Kalava et al.	N	N	60/116	75/123
Janngam et al.	15/54	24/54	21/54	33/54
Bone et al.	9/20	14/20	N	N
Visalyaputra et al.	7/27	10/28	N	N

表2 纳入研究的实验结果

纳入研究	术后呕吐(POV)		术后恶心呕吐(PONV)
Phillips and Hutchinson	4/40	9/40	19/40	25/40
Pongprojpaw and Chiamchanya	7/40	12/40	12/40	23/40
Eberhart et al.	23/57	16/59	30/57	29/59
Nanthakomon et al.	17/60	28/60	29/60	40/60
Kalava et al.	N	N	60/116	75/123
Janngam et al.	15/54	24/54	21/54	33/54
Bone et al.	9/20	14/20	N	N
Visalyaputra et al.	7/27	10/28	N	N

图1 检索流程图

图2 术后0～2 h内两组恶心呕吐发生率的比较

图3 术后6～24 h内两组恶心呕吐发生率的比较

图4 术后24～48 h内两组恶心呕吐发生率的比较

表3 各组数据偏倚的评价

项目	0～2 h	6～24 h	24～48 h
Begg检验P值	0.3272	0.8806	0.2971
Egger检验P值	0.1943	0.3498	0.2391

表3 各组数据偏倚的评价

项目	0～2 h	6～24 h	24～48 h
Begg检验P值	0.3272	0.8806	0.2971
Egger检验P值	0.1943	0.3498	0.2391

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Comparison of Ramosetron′s and Ondansetron′s Preventive Anti-emetic Effects: A Systematic Review and Meta-analysis

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Comparison of Ramosetron′s and Ondansetron′s Preventive Anti-emetic Effects: A Systematic Review and Meta-analysis