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亚甲蓝对实验性术后粘连的影响：系统评价和荟萃分析。

Effect of methylene blue on experimental postoperative adhesion: A systematic review and meta-analysis.

机构信息

Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.

出版信息

PLoS One. 2022 May 19;17(5):e0268178. doi: 10.1371/journal.pone.0268178. eCollection 2022.

DOI:10.1371/journal.pone.0268178
PMID:35588404
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9119438/
Abstract

Adhesion is a primary challenge following surgery, and the anti-adhesive effect of methylene blue (MB) has been investigated. This systematic review and meta-analysis aimed to evaluate the effect of MB on postoperative adhesions in experimental studies. We initially searched OVID-MEDLINE, EMBASE, and Google Scholar in February 2021, and then in May 2021. The anti-adhesive efficacy of MB was compared with that of the control (either placebo or nothing) after the surgical procedure. The primary and secondary outcomes were the macroscopic and microscopic adhesion scores, respectively. Traditional meta-analysis, meta-regression, and trial sequential analysis (TSA) were performed to analyze the retrieved outcomes. We included 13 experimental studies of 367 rats (200 rats received MB and 167 rats received placebo or nothing). The macroscopic adhesion scores were significantly lower in the MB-administered group than in the control group (standardized mean difference, 2.313; 95% confidence interval, 1.104 to3.523; I2 = 94.0%, Tau = 2.059). Meta-regression analysis showed that macroscopic adhesion tended to decrease with an increase in MB dose. TSA demonstrated that the cumulative Z curve crossed both the conventional test and trial sequential monitoring boundary for the macroscopic adhesion score. MB had a beneficial effect on intraperitoneal adhesion following laparotomy, and adhesions decreased with increase in dose.

摘要

粘连是手术后的主要问题，已有研究探讨了亚甲蓝（MB）的抗粘连作用。本系统评价和荟萃分析旨在评估 MB 对实验性研究中术后粘连的影响。我们最初于 2021 年 2 月在 OVID-MEDLINE、EMBASE 和 Google Scholar 进行了检索，然后于 2021 年 5 月再次检索。MB 的抗粘连效果与手术后的对照（安慰剂或空白对照）进行了比较。主要和次要结局分别为宏观和微观粘连评分。对检索结果进行了传统荟萃分析、荟萃回归分析和试验序贯分析（TSA）。我们纳入了 13 项涉及 367 只大鼠的实验研究（200 只大鼠接受 MB，167 只大鼠接受安慰剂或空白对照）。MB 组的宏观粘连评分明显低于对照组（标准化均数差，2.313；95%置信区间，1.104 至 3.523；I2 = 94.0%，Tau = 2.059）。荟萃回归分析显示，宏观粘连倾向于随 MB 剂量增加而减少。TSA 表明，累积 Z 曲线穿过了宏观粘连评分的常规检验和试验序贯监测边界。MB 对剖腹手术后的腹腔内粘连有有益作用，且粘连随剂量增加而减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c03/9119438/8f9f45eb8064/pone.0268178.g010.jpg
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