局部应用倍他米松凝胶预防气管插管术后咽痛的Meta分析

Topical application of betamethasone gel for the prevention of postoperative sore throat： a systematic review and Metaanalysis

目的应用Meta分析方法评价局部使用倍他米松凝胶对预防术后气管插管引起咽痛的有效性。方法计算机检索Cochrane、PubMed、EMbase、MEDLINE数据库（检索截止2015年10月），查找倍他米松应用于全身麻醉气管插管患者的随机对照试验（randomized controlled trails, RCT），并进一步追溯所获文献的参考文献，查阅各种相关会议记录、研究生论文等。按照纳入和排除标准，由两位研究人员选择文献、提取资料，按照Cochrane手册5．0的偏倚风险评估工具对纳入研究的方法学质量进行评价，然后采用RevMan5．0软件进行Meta分析。结果共纳入6个RCT，587例患者，其中倍他米松组294例，对照组293例。Meta分析结果显示：局部应用倍他米松凝胶可以有效降低术后1h咽痛的发生率[比值比（oddsratio，OR）=0．16，95％CI（0．05-0．50）（P〈0．01）]及24h咽痛发生率[OR=O．09，95％CI（0．03—0．23）（P〈0．01]，同时可以有效降低术后24h声音嘶哑发生率[OR=0．25，95％CI（0．15-0．44）（P〈0．01]及24h咳嗽发生率[OR=0．25，95％CI（0．15-0．44）（R0．0130结论对全身麻醉下行气管插管患者，术前预防性局部应用倍他米松凝胶可以有效降低术后咽喉痛的发生率。

Objective To systematically assess the effectiveness of topical application of betamethasone gel to prevent postoperative sore throat after tracheal intubation. Methods Cochrane, PubMed, EMbase, MEDLINE （deadline 2015.10） were searched for relevant literatures. To search randomized controlled trials （RCTs） in which betamethasone was applied to patients with trachea intubation a variety of relevant conference records and graduate thesiswere also manually traced. Two reviewers independently screened the trials according to inclusion and exclusion criteria, extracted the data, and assessed the quality of methodology. Meta-analysis were performed using RevMan 5.0 software. Results A total of 6 randomized controlled trails（RCTs）, 587 patients were enrolled, including 294 cases in betamethasone group, 293 cases in the control group. Meta-analysis results show that the topical application of betamethasone gel can effectively reduce the incidence of sore throat 1 h[odds ratio（OR）=0.16, 95%CI （0.05-0.50）（P〈0.01）] and 24 h [OR =0.25, 95%CI （0.15-0.44）（P〈0.01] after operation. Postoperative 24 h the incidence of hoarseness [OR=0.25, 95%CI（0.15-0.44）（P〈0.01）1 and cough[OR=0.25, 95%CI（0.15-0.44）（P〈0.01）] were also reduced. Conclusions Topical application of betamethasone gel can effectively reduce the incidence of postoperative sore throat in endotracheal intubation patients under general anesthesia.