镰状细胞病患者急性疼痛发作时的液体替代疗法。
Fluid replacement therapy for acute episodes of pain in people with sickle cell disease.
作者信息
Okomo Uduak, Meremikwu Martin M
机构信息
Vaccine and Immunity Theme, Medical Research Council Unit, The Gambia, Atlantic Boulevard, Fajara, Gambia, P.O. Box 273.
出版信息
Cochrane Database Syst Rev. 2017 Jul 31;7(7):CD005406. doi: 10.1002/14651858.CD005406.pub5.
BACKGROUND
Treating vaso-occlusive painful crises in people with sickle cell disease is complex and requires multiple interventions. Extra fluids are routinely given as adjunct treatment, regardless of the individual's state of hydration with the aim of slowing or stopping the sickling process and thereby alleviating pain. This is an update of a previously published Cochrane Review.
OBJECTIVES
To determine the optimal route, quantity and type of fluid replacement for people with sickle cell disease with acute painful crises.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.We also conducted searches of Embase (November 2007), LILACS, www.ClinicalTrials.gov (05 January 2010), and the WHO ICTRP (30 June 2017).Date of most recent search of the Group's Haemoglobinopathies Trials Register: 16 February 2017.
SELECTION CRITERIA
Randomised and quasi-randomised controlled trials that compared the administration of supplemental fluids adjunctive to analgesics by any route in people with any type of sickle cell disease during an acute painful episode, under medical supervision (inpatient, day care or community).
DATA COLLECTION AND ANALYSIS
No relevant trials have yet been identified.
MAIN RESULTS
Sixteen trials were identified by the searches, all of which were not eligible for inclusion in the review.
AUTHORS' CONCLUSIONS: Treating vaso-occlusive crises is complex and requires multiple interventions. Extra fluids, generally oral or intravenous, are routinely administered during acute painful episodes to people with sickle cell disease regardless of the individual's state of hydration. Reports of their use during these acute painful episodes do not state the efficacy of any single route, type or quantity of fluid compared to another. However, there are no randomised controlled trials that have assessed the safety and efficacy of different routes, types or quantities of fluid. This systematic review identifies the need for a multicentre randomised controlled trial assessing the efficacy and possible adverse effects of different routes, types and quantities of fluid administered to people with sickle cell disease during acute painful episodes.
背景
治疗镰状细胞病患者的血管阻塞性疼痛危象很复杂，需要多种干预措施。无论个体的水化状态如何，通常都会额外补充液体作为辅助治疗，目的是减缓或阻止镰变过程，从而减轻疼痛。这是对之前发表的Cochrane系统评价的更新。
目的
确定镰状细胞病急性疼痛危象患者液体补充的最佳途径、量和类型。
检索方法
我们检索了Cochrane囊性纤维化和遗传疾病小组试验注册库，该注册库包含从全面的电子数据库检索以及对相关期刊和会议论文摘要集的手工检索中识别出的参考文献。我们还检索了Embase（2007年11月）、LILACS、www.ClinicalTrials.gov（2010年1月5日）和世界卫生组织国际临床试验注册平台（2017年6月30日）。小组血红蛋白病试验注册库的最新检索日期：2017年2月16日。
入选标准
随机和半随机对照试验，比较在医疗监督下（住院、日间护理或社区），在急性疼痛发作期间，对任何类型镰状细胞病患者通过任何途径给予补充液体作为镇痛药辅助治疗的效果。
数据收集与分析
尚未识别出相关试验。
主要结果
检索到16项试验，所有这些试验均不符合纳入本评价的条件。
作者结论
治疗血管阻塞性危象很复杂，需要多种干预措施。无论个体的水化状态如何，在急性疼痛发作期间，通常会给镰状细胞病患者额外补充液体，一般为口服或静脉注射。关于在这些急性疼痛发作期间使用液体的报告并未说明任何一种途径、类型或量的液体与另一种相比的疗效。然而，尚无随机对照试验评估不同途径、类型或量的液体的安全性和疗效。本系统评价表明需要进行一项多中心随机对照试验，以评估在急性疼痛发作期间给予镰状细胞病患者不同途径、类型和量的液体的疗效及可能的不良反应。
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