右美托咪定对颅脑手术后结局的影响——一项荟萃分析。

Effects of dexmedetomidine on outcomes following craniocerebral operation - a meta-analysis.

作者信息

Wenjie Wang, Houqing Lu, Gengyun Sun

机构信息

Department of ICU, Tongling Clinical College of Anhui Medical University, Tongling 244000, Anhui Province, China(1).

Department of Respiratory Medicine, The First Affiliated Hospital of Medical University of Anhui, Hefei 230022, Anhui Province, China.

出版信息

Clin Neurol Neurosurg. 2014 Oct;125:194-7. doi: 10.1016/j.clineuro.2014.08.009. Epub 2014 Aug 15.

DOI:10.1016/j.clineuro.2014.08.009

PMID:25173961

Abstract

OBJECTIVE

To evaluate the effect of dexmedetomidine on outcomes following craniocerebral operation and provide evidence for individualized medication.

METHODS

We searched the Cochrane Library, PubMed, Springer, CNKI, Wanfang Data Resource and other Chinese and foreign databases with electronic retrieval, within the period 1990-2013, for records relating to dexmedetomidine, brain pharmacokinetics and clinical randomized controlled studies. Records were assessed using the Cochrane system evaluation method for assessing the quality of research, using Revman 5.1 Meta-analysis software.

RESULTS

After screening and removal of duplicate documents there were 22 English and 44 Chinese articles, among which there were eight describing clinical trials, with a total of 412 cases. Meta-analysis showed that dexmedetomidine on rate during craniocerebral operation (standardized mean difference=-8.32, 95% confidence interval [CI] -10.38 to 6.26, P<0.00001), and blood pressure (standardized mean difference=-3.37, 95% CI -5.36 to 1.38, P<0.00001). The study had good heterogeneity using random effects model analysis, and there was no publication bias.

CONCLUSION

Dexmedetomidine can reduce the hemodynamic response and play a role in brain protection.

摘要

目的

评估右美托咪定对颅脑手术后结局的影响，为个体化用药提供依据。

方法

采用电子检索方式，检索1990年至2013年期间的Cochrane图书馆、PubMed、Springer、中国知网、万方数据资源等中外数据库，查找与右美托咪定、脑药代动力学及临床随机对照研究相关的记录。采用Cochrane系统评价方法评估研究质量，使用Revman 5.1荟萃分析软件。

结果

筛选并去除重复文献后，获得英文文献22篇，中文文献44篇，其中8篇描述临床试验，共412例。荟萃分析显示，右美托咪定可降低颅脑手术期间的心率（标准化均数差=-8.32，95%置信区间[CI]-10.38至6.26，P<0.00001）及血压（标准化均数差=-3.37，95%CI-5.36至1.38，P<0.00001）。采用随机效应模型分析，研究具有良好的异质性，且无发表偏倚。