奥曲肽治疗肠梗阻疗效的Meta分析.doc

奥曲肽治疗肠梗阻疗效的meta分析 刘汉东，李晓娇 (1金堂县第一人民医院外一科) 摘要 目的 评价奥曲肽治疗肠梗阻的临床疗效。方法 全面搜集以奥曲肽疗法治疗肠梗阻相关的随机对照或半随机对照临床试验文献，对入选文献进行Jadad评分，质量评价，运用Review Manager 5.0统计相关数据作异质性检验，敏感性分析，Mete分析，漏斗图分析，得出系统评价。结果 9篇文献符合纳入标准,奥曲肽试验组与常规疗法对照组共595个病例。Meta分析显示合并总有效率OR值为2.83，95％可信区间为1.75～4.58，菱形位于垂线右侧(z=4.25，P0.00001)，差异有统计学意义。另外胃肠减压量，肛门排气时间，住院时间三个方面比较均有统计学意义，试验组优于对照组。结论 从统计结果分析，可认为奥曲肽治疗肠梗阻疗效优于常规疗法，但所纳入的文献质量普遍偏低且样本量偏小,势必影响结果的论证强度,故尚需更高质量的随机对照试验，提供高质量的证据。 关键词 奥曲肽；肠梗阻；meta分析A Meta analysis on octreotide for Intestinal obstructio ABSTRACT Objective To evaluate the clinical effects of octreotide in treatment of Intestinal obstructio. Methods Based on the databases getting from medical literatures relating to octreotide in treatment of Intestinal obstructio, which conducted by randomized controlled trials (RCT) or semi-randomized controlled trials. Then made a quality evaluation by Jadad scoring method, and took statistics of the correlated data with the methods of heterogeneity test, sensitivity analysis Meta analysis and filler-graph analysis by Review Manager 5.0. Results 9 articles were included into the system evaluation. The baseline characteristics of the experiment group and the control group are 595 cases in total. The total effective rate comparison odds ratio(OR) to merge equaled 2.83, 95% confidence interval (CI) was(1.75～4.58).Rhombus located at the right of the Perpendicular (z=4.25，P0.00001).The results have Statistically significant difference. The average gastrointestinal drainage and the average anal exhaust time advanced obviously．The average hospitalization time also shortened. Conclusion Our systemic evaluation shows the clinical effects of octreotide is better than that of routine treatment in treatment of Intestinal obstructio. However the quality of literatures needs to be improved which will influence the argumentation intensity of the conclusion. So more high-quailty RCTs are needed to provide high-quailty proof. Key words: Octreotide; Intestinal obstructio ; Meta analy