【摘要】：目的評(píng)價(jià)利伐沙班在用于骨科術(shù)后患者靜脈血栓栓塞預(yù)防方面的有效性和安全性。方法系統(tǒng)檢索Pub Med、Em Base、Cochrane Library、Web of Science、Clinical Trials、中國(guó)知網(wǎng)(CNKI)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM)、萬(wàn)方數(shù)據(jù)庫(kù),檢索時(shí)間均從建庫(kù)至2016年8月。篩選出利伐沙班單藥或者聯(lián)合其他常規(guī)用藥用于骨科術(shù)后患者靜脈血栓預(yù)防的所有隨機(jī)對(duì)照試驗(yàn)(RCTs),比較總靜脈血栓栓塞、嚴(yán)重靜脈血栓栓塞、深靜脈血栓、肺栓塞、全因死亡、癥狀性靜脈血栓栓塞等有效性結(jié)局及出血、大出血、臨床相關(guān)非大出血、輕微出血、傷口并發(fā)癥等安全性結(jié)局事件的發(fā)生率。結(jié)果以相對(duì)危險(xiǎn)系數(shù)(RR)及其95%置信區(qū)間(CI)表示,用Rev Man 5.3軟件進(jìn)行Meta分析。結(jié)果共納入32項(xiàng)RCTs研究,涉及17061例患者,其中試驗(yàn)組9167例,對(duì)照組7894例。Meta分析結(jié)果顯示,與低分子肝素相比,在癥狀性靜脈血栓栓塞、總靜脈血栓栓塞、嚴(yán)重靜脈血栓栓塞、深靜脈血栓事件發(fā)生率方面,試驗(yàn)組顯著低于對(duì)照組(P0.05),其他安全性指標(biāo)差異均無(wú)統(tǒng)計(jì)學(xué)意義;與阿司匹林相比,在總靜脈血栓栓塞、深靜脈血栓事件發(fā)生率方面,試驗(yàn)組顯著低于對(duì)照組(P0.05),其他安全性指標(biāo)差異均無(wú)統(tǒng)計(jì)學(xué)意義;與阿哌沙班相比,在有效性及安全性方面差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論利伐沙班用于骨科術(shù)后患者靜脈血栓栓塞預(yù)防的療效顯著優(yōu)于低分子肝素及阿司匹林,且不會(huì)顯著增加出血、傷口并發(fā)癥等風(fēng)險(xiǎn)。
[Abstract]:Objective to evaluate the efficacy and safety of Lipashaban in the prevention of venous thromboembolism after orthopedic surgery. Methods A systematic search was conducted for the Pub Meden Em Base Library Web of Science Clinical Trials, and the (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang database. The retrieval time was from the establishment of the database to August 2016. All randomized controlled trials (RCTs), which were selected for the prevention of venous thrombosis in orthopedic patients with single drug or other conventional drugs, were compared with total venous thromboembolism, severe venous thromboembolism, deep venous thrombosis, pulmonary embolism, and death. The effective outcome of symptomatic venous thromboembolism and the incidence of safe outcome events such as bleeding, massive hemorrhage, clinical associated non-massive hemorrhage, minor bleeding, wound complications, etc. Results the relative risk coefficient (RR) and its 95% confidence interval (CI) were used for Meta analysis with Rev Man 5.3 software. Results A total of 32 RCTs studies involved 17061 patients, including 9167 patients in the trial group and 7894 patients in the control group. Meta-analysis showed that compared with low molecular weight heparin, symptomatic venous thromboembolism, total venous thromboembolism, and severe venous thromboembolism were found in patients with symptomatic venous thromboembolism, total venous thromboembolism and severe venous thromboembolism. The incidence of deep venous thromboembolism in the trial group was significantly lower than that in the control group (P0.05), and there was no significant difference in other safety indicators. Compared with aspirin, the incidence of total venous thromboembolism and deep venous thromboembolism in the trial group was significantly lower than that in the control group. The experimental group was significantly lower than the control group (P0.05), other safety indicators were not statistically significant; compared with the piperazaban, there was no significant difference in efficacy and safety. Conclusion Levasaban is more effective than low molecular weight heparin and aspirin in the prevention of venous thromboembolism after orthopedic surgery and does not increase the risk of bleeding and wound complications.
【作者單位】： 北京大學(xué)第三醫(yī)院藥劑科;
【分類號(hào)】：R687.3

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本文編號(hào)：2166822