摘要
目的:评价亚洲人群低分子肝素预防全膝关节置换术后深静脉血栓形成的有效性和安全性。方法:计算机检索Cochrane Library、Pubmed、EMBASE、CNKI、CBM以及万方数据库,纳入相关文献。用Revman5.0软件进行Meta分析。结果:共纳入6篇研究(n=1 178),实验组568例,对照组610例。比较低分子肝素组与对照组的有效性和安全性,结果显示:深静脉血栓形成发生率分别为23.0%和27.9%[Odds Ratio(OR)=0.29,P<0.01];肺栓塞发生率为0.4%和0.5%[Risk Differ-ence(RD)=0,P=0.61];出血发生率分别为6.8%和3.3%(RD=0.02,P=0.20);大出血发生率分别为1.2%和0.7%(RD=0,P=0.79)。异质性检验表明,各研究之间均不存在异质性差异。结论:现有研究显示低分子肝素对亚洲人群全膝关节置换术后深静脉血栓形成的预防有效,且安全性好。但仍需更多高质量、大规模的临床随机对照试验,以提供更可靠的证据。
OBJECTIVE To evaluate the efficacy and safety of prophylactic use of low-molecular-weight heparin（LMWH） for deep venous thrombotic （DVT） after total knee arthroplasty（TKA） in Asian patients. METHODS Pubmed, Cochrane Library, EMBASE, CNKI, CBM and Wanfang Data were searched by computer for investigating the efficacy and safety of prophylactic use of LMWH for DVT after TKA in Asian patients. Limited time from 1979 to 2009. 9. A meta-analysis was performed with the Review Manager 5. RESULTS Six literatures were included （n = 1,178）, 2 in Chinese, 4 in English. Comparing the LMWH group（n = 568）with the control group（n = 610）, the results of Meta-analysis showed as follow= （1）the incidence of DVT： LMWH could prevent DVT after TKA effectively[Odds Ratio（OR） = 0. 32,95%CI（0. 22,0. 45）, P〈0. 01]; （2）the incidence of pulmonary embolism （PE） ： the result of Meta-analysis demonstrated that the PE incidence had no statistical difference[Risk Difference（RD） = 0,95 % CI （ - 0. 02, 0. 01 ）, P = 0. 61 ] ; （3） the bleeding incidence： there was no statistical difference between LMWH group and control group[RD= 0. 02,95 %CI （ - 0. 01 ,0. 05）, P = 0.20] ; （4）the incidence of massive haemorrhage： the result of analysis showed that incidence had no statistical difference [RE）= 0.95%Ci （ -0. 02,0. （12）, P = 0. 79]. There was no heterogeneity. CONCLUSION The studies demonstrated that LMWH can provide effective and safe prophylaxis of DVT after TKA in Asian patients.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2011年第6期483-487,共5页
Chinese Journal of Hospital Pharmacy
