地塞米松对全髋关节置换术后早期的影响

A meta-analysis on the effect of dexamethasone on pain, nausea and vomiting following primary total hip arthroplasty

[目的]探讨初次全髋关节置换术(THA)围术期应用地塞米松对术后早期的影响。[方法]利用计算机检索Pubmed, Web of science, EMBASE, Cochrane Library, CNKI和万方等数据库中地塞米松在初次单侧THA中的应用研究,截止时间2019年3月,提取数据,采用RevMan 5.3软件进行荟萃分析。[结果]研究共纳入临床RCTs 8篇,数据分析结果显示地塞米松可显著降低THA术后24 h (MD=-0.88,95%CI:-1.19^-0.56,P<0.001)和48 h的VAS评分(MD=-0.64,95%CI:-1.15^-0.13,P=0.01),缩短住院时间(MD=-0.75,95%CI:-0.96^-0.55,P<0.001),降低术后恶心呕吐的发生率(OR=0.12,95%CI:0.07~0.21,P<0.001)。[结论]初次单侧THA围术期应用地塞米松可显著缓解术后疼痛,缩短住院时间,同时降低术后恶心呕吐的发生率。

[Objective] To assess the effect of dexamethasone on pain, nausea and vomiting following primary total hip arthroplasty(THA). [Methods] Literatures on the application of dexamethasone following primary THA were retrieved from databases, such as Pubmed, Web of Science, EMBASE, Cochrane Library, CNKI and VIP before March 2019. The related data collected were statistically analyzed using RevMan 5.3 software to compare the occurrence of pain, nausea and vomiting in the early stage after operation. [Results] A total of 8 high quality prospective clinical RCTs meeting the inclusion criteria were included into this study. As results of the meta-analysis, the dexamethasone significantly decreased the VAS score in 24 hours(MD=-0.88, 95% CI :-1.19^-0.56, P<0.001) and in 48 hours(MD=-0.64, 95% CI:-1.15^-0.13, P=0.01), as well as significantly reduced hospital stay(MD=-0.75, 95% CI:-0.96^-0.55, P<0.001), and significantly declined the incidence of nausea and vomiting(OR=0.12, 95% CI: 0.07~0.21, P<0.001) after primary THA. [Conclusion] The application of dexamethasone effectively relieve pain, shorten hospital stay, as well as decline the incidence of nausea and vomiting after primary THA.