托烷司琼预防全麻术后恶心呕吐效果的Meta分析

A Meta-analysis of efficacy of tropisetron for postoperative nausea and vomiting

目的:系统评价托烷司琼预防全麻术后恶心呕吐(PONV)的有效性。方法:电子搜索PubMed,CNKI等数据库,收集1990-2010年发表的关于托烷司琼预防术后恶心呕吐的研究,按Cochrane系统评价的方法评价其质量,并提取资料,采用Review Manager 4.2软件进行统计分析。结果:Meta分析表明,诱导前静注托烷司琼较术毕静注托烷司琼术后恶心呕吐的发生率低[OR(95%CI)为0.34(0.13,0.89)],但都低于空白对照组PONV的发生率[OR(95%CI)分别为0.09(0.05,0.17),0.31(0.19,0.49)]。托烷司琼5 mg昂丹司琼4或8 mg预防PONV的效果无统计学差异[OR(95%CI)分别为0.88(0.54,1.45)和0.47(0.20,1.06)]。结论:诱导前或术毕静注托烷司琼能减少恶心呕吐的发生率,且诱导前静注效果更佳。而托烷司琼与同类药物昂丹司琼在降低PONV的发生率方面没有明显的差异。

Objective： To systematically evaluate the efficacy of tropisetron for postoperative nausea and vomiting （PONV）. Methods： We collected articles about tropisetron for PONV by searching PubMed, CNK! and many other databases from 1990 to 2010. They were identified according to the Cochrane Handbook. The homogeneous randomized, controlled trials （RCTs） were analyzed with Review Manager 4.2 software. Results： The PONV incidence in patients administered with tropisetron preoperatively was lower than postoperatively [ OR （95% CI） was 0.34 （0.13 -0.89） ] , but both of them were lower than those administered saline [ OR （95% CI） was 0. 09 （0.05 ~ 0.17） and 0.31 （0.19 -0.49） ]. There was no difference between the patients administered 5 mg tropisetron and 4mg （or 8 mg） ondanstron. Conclusion： Preoperative and postoperative administration of tropisetron can effectively reduce the occurrence of PONV, and preoperatively medication is much better. However, compared with ondanstron, tropisetron has the similar efficacy on nreventine PONV.