右美托咪啶和咪达唑仑用于程序化镇静疗效和安全性的系统评价

doi:10.13481/j.1671-587x.20170420

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (04): 762-769.doi: 10.13481/j.1671-587x.20170420

右美托咪啶和咪达唑仑用于程序化镇静疗效和安全性的系统评价

丁显飞, 袁博, 许振涛, 郑少华, 马燕, 师培娜, 孙同文

郑州大学第一附属医院综合ICU 河南省重症医学重点实验室, 河南郑州 450052

收稿日期:2017-04-08 出版日期:2017-07-28 发布日期:2017-08-01
通讯作者: 孙同文,教授,博士研究生导师(Tel:0371-67966537,E-mail:suntongwen@163.com) E-mail:suntongwen@163.com
作者简介:丁显飞(1990-),男,河南省周口市人,在读医学博士,主要从事急危重症及高血压的基础和临床方面的研究。
基金资助:
国家自然科学基金面上项目资助课题（81370364）；河南省教育厅高校科技创新团队资助课题（16IRTSTHN021）；河南省卫计委卫生科技创新人才资助课题（豫卫科2010-52）；河南省卫计委医学科技攻关省级共建项目资助课题（201301005）

Dexmedetomidine and midazolam in procedural sedation:a systematic review of efficacy and safety

DING Xianfei, YUAN Bo, XU Zhentao, ZHENG Shaohua, MA Yan, SHI Peina, SUN Tongwen

General ICU, First Affiliated Hospital, Zhengzhou University, Henan Key Laboratory of Critical Care Medicine, Zhengzhou 450052, China

Received:2017-04-08 Online:2017-07-28 Published:2017-08-01

摘要/Abstract

摘要： 目的：系统评价右美托咪定和咪达唑仑用于程序化镇静时的疗效和安全性。方法：计算机检索PubMed、EMBase、Cochrane Library、CNKI、CBM和万方等数据库，全面收集右美托咪啶和咪达唑仑用于程序化镇静效果比较的临床随机对照试验（RCT），检索时限为建库至2017年3月。根据纳入标准筛选文献，并进行数据提取和质量评价，对研究结局进行系统评价。疗效结局指标为患者和医生的满意度评分、疼痛评分；安全性结局指标为低血压、低氧血症、循环和呼吸系统等并发症的发生率。结果：最终纳入14项RCT，共949例患者。与咪达唑仑组比较，右美托咪啶组患者的疼痛、谵妄发生率及镇痛需求比较差异均有统计学意义（P<0.05）；但呼吸抑制和低血压发生率比较差异无统计学意义（P>0.05）。结论：成年患者镇静时，右美托咪定可以作为咪达唑仑镇静的理想替代药物。

关键词: 咪达唑仑, 程序化镇静, 系统评价, 右美托咪啶, Jadad量表

Abstract: Objective: To systematically review the efficacy and safety of dexmedetomidine and midazolam in procedural sedation.Methods: PubMed,EMBase,Cochrane Library,CNKI,CBM and WanFang databases were retrieved to collect the randomized controlled trials (RCT) about comparion of efficacy and safety between dexmedetomidine and midazolam in procedural sedation up to March, 2017. Based on the inclusion criteria, the data extraction and quality evaluation were performed, and then the systematic evaluation was carried out.The outcome measures for efficacy were the satisfaction scores and pain scores of the patients and clinicians;the outcome measures for safety comparison were hypotension, hypoxia, and circulatory and respiratory complications.Results: There were 14 RCT satisfied the inclusion criteria including 949 patients. Compared with midazolam group, the incidence of pain, delirium, and analgesia of the patients in dexmedetomidine group had significant differences (P<0.05); but the incidence of respiratory depression, low blood pressure had no significant differences (P>0.05).Conclusion: When the adult patients are sedated, dexmedetomidine can be used as an ideal alternative to midazolam sedation.

Key words: Jadad scale, systematic review, dexmedetomidine, midazolam, procedural sedation

中图分类号:

R614

丁显飞, 袁博, 许振涛, 郑少华, 马燕, 师培娜, 孙同文. 右美托咪啶和咪达唑仑用于程序化镇静疗效和安全性的系统评价[J]. 吉林大学学报(医学版), 2017, 43(04): 762-769.

DING Xianfei, YUAN Bo, XU Zhentao, ZHENG Shaohua, MA Yan, SHI Peina, SUN Tongwen. Dexmedetomidine and midazolam in procedural sedation:a systematic review of efficacy and safety[J]. Journal of Jilin University Medicine Edition, 2017, 43(04): 762-769.

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右美托咪啶和咪达唑仑用于程序化镇静疗效和安全性的系统评价

Dexmedetomidine and midazolam in procedural sedation:a systematic review of efficacy and safety

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