氢吗啡酮患者自控镇痛治疗癌痛的疗效及安全性Meta分析

Efficacy and safety of hydromorphone patient controlled analgesia in the treatment of cancer pain:a Meta-analysis

目的系统评价氢吗啡酮患者自控镇痛(PCA)治疗癌痛的疗效及安全性。方法计算机检索Pubmed、Web of Science、Cochrane library、CBM、中国知网(CNKI)、万方数据库、维普数据库,收集有关氢吗啡酮自控镇痛治疗癌痛的随机对照试验(RCTs),检索日期从建库至2022年7月,由两位研究者独立筛选文献、提取数据、评价纳入研究的偏倚风险并交叉核对后,采用RevMan 5.4软件进行Meta分析。结果共纳入8项研究,736例患者。Meta分析结果显示氢吗啡酮自控镇痛较经典药物镇痛疗效差异无统计学意义(P>0.05),但能改善患者生活质量、降低恶心呕吐与便秘发生率,差异具有统计学意义(P<0.05)。结论证据表明,氢吗啡酮自控镇痛与经典药物镇痛疗效无明显劣势,但能改善患者生活质量、降低恶心呕吐与便秘发生率,成为癌痛治疗的新选择。

Objective To systematically evaluate the efficacy and safety of patient controlled analgesia(PCA)with hydromorphone in treating cancer pain.Methods Pubmed,Web of science,Cochrane library,CBM,CNKI,Wanfang database,and VIP database were electronically searched from inception to July 2022 to collect randomized controlled trials(RCTs)on hydromorphone patient-controlled analgesia in the treatment of cancer pain.Two researchers independently screened literatures,extracted data,evaluated the risk of bias of included studies,and cross-checked,and then used RevMan 5.4 software to conduct Meta-analysis.Results A total of 8 studies with 736 patients were included.Meta-analysis results showed that there was no significant difference in the analgesic efficacy of hydromorphone patient-controlled analgesia compared with classical drugs(P>0.05),but it could improve the quality of life of patients and reduce the incidence of nausea,vomiting and constipation,and the difference was statistically significant(P<0.05).Conclusion The current evidence shows that hydromorphone controlled analgesia has no obvious disadvantage compared with classical drug analgesia,but it can improve the quality of life of patients,reduce the incidence of nausea,vomiting and constipation,and become a new choice of cancer pain treatment.