奥曲肽治疗术后早期炎症性肠梗阻临床疗效和安全性的Meta分析

The clinical efficacy and safety of octreotide in the treatment of early postoperative inflammatory small bowel obstruction:a meta-analysis

目的评价奥曲肽治疗术后早期炎症性肠梗阻的临床疗效和安全性。方法在CNKI、VIP、PubMed、CBM、Web of Science数据库系统检索奥曲肽治疗术后早期炎症性肠梗阻的临床随机对照试验(随机对照试验),依据Cochrane国际协作网评价员工作手册规程,对纳入Meta分析的文献进行质量评价和偏倚分析,运用RevMan 5.2对数据进行统计学分析。结果13项随机对照试验,916例患者纳入研究,Meta分析结果显示奥曲肽治疗术后早期炎症性肠梗阻在胃肠减压引流量[WMD=-403.30(95%CI:-532.99,-273.62)]、肛门恢复排气时间[SMD=-1.33(95%CI:-1.75,-0.91)]、住院时间[WMD=-4.19(95%CI:-5.79,-2.59)]有潜在的临床疗效,同时无严重的药物不良反应(P=0.050)。结论奥曲肽在治疗术后早期炎症性肠梗阻方面有一定的优势,改变奥曲肽给药方式可能减少药物不良反应。

Objective To evaluate the clinical efficacy and safety of octreotide in the treatment of early postoperative inflammatory small bowel obstruction(EPISBO).Methods Databases including CNKI,VIP,PubMed,CBM and Web of Science were searched against to find the randomized controlled trials(RCTs)on the effect of octreotide in the treatment of EPISBO.The study quality and risk of bias were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions,and the data were analyzed by Review Manager 5.2 software.Results A total of 13 RCTs with 916 patients were included.The results of meta-analysis showed that the octreotide reduced the gastric drainage volume[WMD=-403.30(95%CI:-532.99,-273.62)],shortened the time to first flatus[SMD=-1.33(95%CI:-1.75,-0.91)],and shortened the length of hospital stay[WMD=-4.19(95%CI:-5.79,-2.59)].In addition,octreotide did not increase the risk of adverse drug events.Conclusions The clinical efficacy of octreotide is better than the routine treatment for EPISBO.Changing the route of administration of octreotide may lower the risk of adverse drug events.