摘要
目的系统评价围手术期使用盐酸氨溴索对肺的保护效果。方法采用Cochrane系统评价方法,计算机检索Cochrane图书馆、PubMed、EMbase、中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库,并辅以手工检索。由2名评价者独立评价并交叉核对纳入研究的质量,对同质研究采用RevMan5.0.0软件进行Meta分析。结果共纳入8个随机对照试验包括629例患者。纳入研究的方法学质量均为C级。Meta分析结果显示:盐酸氨溴索组与对照组相比,在肺不张、肺部并发症、咳嗽程度、咳痰容易程度的发生率差异均有统计学意义,其RR(95%CI)分别为0.44(0.25,0.78)、0.51(0.34,0.75)、0.39(0.16,0.94)、0.22(0.09,0.53);在痰量、痰液性状、肺部啰音、肺泡表面活性物质等指标方面,盐酸氨溴索组也明显优于对照组?崧?围手术期静脉使用盐酸氨溴索可以有效改善术后呼吸系统症状,减少肺不张等肺部并发症的发生,术前应用氨溴索还能减少手术时机械损伤造成的肺表面活性物质下降,可以起到良好的肺保护作用。但限于纳入研究方法学质量上的局限性,本系统评价结果尚需要大样本、多中心、前瞻性的随机对照研究进一步验证。
Objective To systematically review the efficacy of ambroxol for lung protection in perioperative period. Methods We followed the Cochrane Collaboration methodology to conduct systematic reviews. We searched relevant randomized controlled trials （RCTs） from The Cochrane Library, PubMed, Embase, CBM, CNKI and VIP. We assessed the methodological quality for each outcome by grading the quality, and used RevManS.0.0 to perform meta-analysis. Results Eight RCTs were eligible and included 669 patients. All of these trials used randomization but the quality scales were B. Compared to the control group, the ambroxol group had a statistically significant benefit in atelectasis, pulmonary complications, cough and expectoration degree. The RR （95%CI） were 0.44 （0.25, 0.78）, 0.51 （0.34, 0.75）, 0.39 （0.16, 0.94） and 0.22 （0.09, 0.53）, respectively. The ambroxol group was also better than the control group in sputum volume, sputum characteristics, tales and pulmonary surfactant. Conclusion Ambroxol can improve respiratory system symptoms post-operatively, reduce pulmonary complications, and prevent pulmonary surfactant from decreasing during operation. Ambroxol has a satisfactory lung protective effect in the preoperative period, but we can＇t define a proper dose and usage time.
出处
《中国循证医学杂志》
CSCD
2009年第5期558-564,共7页
Chinese Journal of Evidence-based Medicine
关键词
围手术期
氨溴索
肺保护
系统评价
Perioperative period
Ambroxol
Lung protection
Systermatic review
