丁溴东莨菪碱对腺瘤检出率的影响：随机临床试验的荟萃分析
Effect of hyoscine N-butylbromide on adenoma detection rate: meta-analysis of randomized clinical trials.
作者信息
Madhoun Mohammad F, Ali Tauseef, Tierney William M, Maple John T
机构信息
Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, USA; Veteran Affairs Medical Center, Oklahoma City, USA.
出版信息
Dig Endosc. 2015 Mar;27(3):354-60. doi: 10.1111/den.12340. Epub 2014 Oct 16.
BACKGROUND AND AIM
Anti-spasmodic drugs may facilitate mucosal inspection during colonoscopy. The impact of hyoscine N-butylbromide (HBB) on polyp detection rate (PDR) and adenoma detection rate (ADR) is unclear.
METHODS
We conducted a reproducible literature search of multiple databases. Two reviewers independently compared manuscripts for PDR, ADR, advanced adenoma detection rate (AADR), and rates of complications. Pooling was conducted by fixed-effects and random-effects models. Relative risk (RR) estimates were calculated (95% confidence interval). I(2) index assessed heterogeneity.
RESULTS
Patient demographics were comparable. The pooled analysis showed a trend toward improving PDR and ADR among the HBB group compared with the placebo group but failed to reach statistical significance, (46% vs 43%, RR = 1.08 [0.94, 1.25], P = 0.27), (31% vs 28%, RR = 1.12 [0.97, 1.29], P = 0.11) respectively.
CONCLUSION
HBB during colonoscopy may provide marginal improvements in ADR and PDR. However, heterogeneity in the available data precludes firm conclusions at this time.
背景与目的
抗痉挛药物可能有助于结肠镜检查时的黏膜观察。丁溴东莨菪碱（HBB）对息肉检出率（PDR）和腺瘤检出率（ADR）的影响尚不清楚。
方法
我们对多个数据库进行了可重复的文献检索。两名评价者独立比较了关于PDR、ADR、高级别腺瘤检出率（AADR）及并发症发生率的手稿。采用固定效应模型和随机效应模型进行合并分析。计算相对风险（RR）估计值（95%置信区间）。I²指数评估异质性。
结果
患者人口统计学特征具有可比性。汇总分析显示，与安慰剂组相比，HBB组在改善PDR和ADR方面有一定趋势，但未达到统计学显著性，PDR分别为（46%对43%，RR = 1.08 [0.94, 1.25]，P = 0.27），ADR分别为（31%对28%，RR = 1.12 [0.97, 1.29]，P = 0.11）。
结论
结肠镜检查期间使用HBB可能在ADR和PDR方面带来微小改善。然而，现有数据的异质性使得目前无法得出确切结论。
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