超前镇痛对开胸术后疼痛综合征发生影响的Meta分析.pdfVIP

2008年第24卷第2期 包 头 医 学 院 学 报一 Vo1．24 No．2 2008 JoURNAL oF BAoToU MEDICAL CoLLEGE 123 超前镇痛对开胸术后疼痛综合征发生影响的Meta分析 陶利军 (内蒙古医学院附属医院麻醉科，内蒙古 呼和浩特010017) 摘 要 目的：对超前镇痛能否预防开胸术后疼痛综合征的发生进行系统评价。方法：计算机检索MEDLINE(1990 — 2006．6)、EMBASE(1989—2006．6)及中国生物医学文献数据库(CBM)(1978—2006．6)，手工检索纳人试验的所有中 文及外文文献及相关文献，收集所有对有关超前镇痛与开胸术后疼痛综合征的随机对照临床试验，对其逐个进行方法学 质量评价，并用RevMan4．2．8进行Meta分析。结果：共纳入2个随机对照试验，99例应用超前镇痛行开胸手术的患者； 均为高质量研究，Meta分析结果显示：超前镇痛组与对照组比较在随访时间内其效应间差异无统计学意义，开胸术后慢 性痛合并优势比为0．51[95％CI(0，19，1．34)，P=0．17]。结论：目前无足够证据证明超前镇痛能够有效预防和降低开 胸术后慢性痛的发生，尚需要更多设计严谨、方法科学的高质量随机对照试验。 关键词 超前镇痛；疼痛；胸部手术；Meta分析 A Meta—·analysis of the Effect of Preemptive Analgesia on the Post—·thoracotomy Pain Syndrome TAO Lijlm (Department ofAnaesthesia，the Affiliated Hosphal ofInner Mongo~a Medical College，Huhehot 010050，China) Abstract Objective：To examine whether preemptive analgesia can prevent the post—thoractomy pain syndrome．Methods： Using the methods of The Cochrane Collaboration，a systematic review of the relevant randomized contro1]试als(RCTs)of pre— emptive analgesia for chronic pest—thoracotomy pain was performed．The literature related to trials was collected form MEDLINE (1990—2006．6)，EMBASE(1989—2006．6)，CBM(1978—2006．6)，and all articles in Chinese and English involved in trails were handsearched．The quality of literature was reviewed，and data were extracted by two reviewers independently．Meta— analysis was conducted using RevMan 4．2 software．Results：Two RCTs involving 99 patients were included and all were of higlI methodological quality according to Jadad scale(the Jadad SCOre3)．Meta—analysis indicated that no statistical difference was detected between preemptive analgesia group and the contro1]groups in effectiv