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地塞米松预防经动脉化疗栓塞术引起的不良事件:一项荟萃分析。

Dexamethasone prevents TACE-induced adverse events: A meta-analysis.

作者信息

Chang Lei, Wang Wei, Jiang Nanhui, Rao Fengying, Gong Cheng, Wu Ping, Yang Jian, Liu Zhisu, Guo Tao

机构信息

Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan.

School of Nursing, Huanggang Polytechnic College, Huanggang.

出版信息

Medicine (Baltimore). 2020 Nov 20;99(47):e23191. doi: 10.1097/MD.0000000000023191.

Abstract

BACKGROUND

While dexamethasone has been applied following transcatheter arterial chemoembolization (TACE) for years, its clinical effects have not been determined. In the current study, we aimed to evaluate the efficacy of dexamethasone in preventing adverse events induced by TACE.

METHODS

Literature retrieval was conducted using globally recognized online databases, namely MEDLINE, EMBASE, and Cochrane Central, to identify randomized controlled trials (RCTs) of dexamethasone application in patients undergoing TACE. The relative odds ratios (ORs) of incidence rates of three adverse events, namely, fever, abdominal pain and nausea/vomiting, were calculated. The value of I was applied to evaluate the heterogeneity of the trials, and the overall publication bias was assessed with Egger test.

RESULTS

Four RCTs containing 350 subjects were included for the pooled estimation. Dexamethasone significantly reduced the incidence rate of TACE-induced adverse events (OR = 1.237, 95% CI: 1.170-1.308, P < .001) with moderate heterogeneity (I = 46.0%). The result of Egger test revealed a publication bias for the included studies.

CONCLUSION

The current meta-analysis confirmed the efficacy of dexamethasone in preventing TACE-induced adverse events. To confirm the practicality of dexamethasone use with TACE, further studies with large sample sizes are warranted to update the evidence-based analyses.

摘要

背景

多年来,地塞米松一直用于经动脉化疗栓塞术(TACE)后,但尚未确定其临床效果。在本研究中,我们旨在评估地塞米松预防TACE引起的不良事件的疗效。

方法

使用全球公认的在线数据库(即MEDLINE、EMBASE和Cochrane Central)进行文献检索,以确定地塞米松应用于接受TACE治疗患者的随机对照试验(RCT)。计算了三种不良事件(即发热、腹痛和恶心/呕吐)发生率的相对比值比(OR)。应用I值评估试验的异质性,并用Egger检验评估总体发表偏倚。

结果

纳入四项包含350名受试者的RCT进行汇总估计。地塞米松显著降低了TACE引起的不良事件的发生率(OR = 1.237,95%CI:1.170 - 1.308,P <.001),异质性中等(I = 46.0%)。Egger检验结果显示纳入研究存在发表偏倚。

结论

当前荟萃分析证实了地塞米松预防TACE引起的不良事件的疗效。为确认地塞米松与TACE联合使用的实用性,有必要开展进一步大样本研究以更新循证分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec0/7676579/9d954a073a24/medi-99-e23191-g001.jpg

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