摘要
目的系统评价亚甲蓝局部注射减轻肛肠疾病术后疼痛的效果。方法通过Pubmed、Embase、Cochrane Library、Clinical Trials、CBM、CNKI、VIP、万方等数据库检索亚甲蓝局部注射治疗肛肠疾病术后疼痛的患者1 414例,共纳入11项RCT,并进行文献质量评价和资料提取,采用Rev Man 5.3版进行Meta分析。结果 Meta分析结果显示,与对照组相比,试验组能降低术后6 h(MD=-2.30,95%CI:-5.69～-1.90)、12 h(MD=-2.47,95%CI:-3.00～-1.94)、1 d(MD=-1.92,95%CI:-2.89～-0.94)、2 d(MD=-2.67,95%CI:-3.92～-1.41)、3 d(MD=-1.99,95%CI:-3.12～-0.87)、5 d(MD=-1.34,95%CI:-2.37～-0.31)、7 d(MD=-1.46,95%CI:-1.83～-1.08)的VAS评分。同时,与对照组比较,亚甲蓝还可降低术后并发症的发生率(RR=0.36,95%CI:0.20～0.66)。结论亚甲蓝可减轻肛肠疾病术后患者的疼痛,降低并发症发病率,但仍需开展更多高质量的临床研究,进一步探讨其临床应用价值。
外文提要
OBJECTIVE To evaluate the Analgesic efficacy of methylene blue local injection on anorectal disease post-operation.METHODS We searched the following databases: Pubmed,Embase,Cochrane Library,Clinical Trials,CBM,CNKI,VIP and WanFang to identify RCTs refer to methylene blue local injection on anorectal disease post-operation. Meta-analysis was performed by using Rev Man 5.3 software. RESULTS A total of 11 RCTs involving 1 414 anorectal disease patients were included.Compared with controlled,the experimental group decreased postoperative visual analog scale score at 6 h( MD =-2.30,95% CI:-5. 69--1. 90),12 h( MD =-2.47,95%CI:-3.00--1.94),1 d( MD =-1. 92,95% CI:-2. 89--0. 94),2 d( MD =-2. 67,95% CI:-3. 92--1. 41),3 d( MD =-1.99,95%CI:-3.12--0.87) 5 d( MD =-1.34,95% CI:-2.37--0.31),7 d( MD =-1.46,95% CI:-1.83--1.08),and reduced the incidence of postoperative complication significantly( RR = 0.36,95% CI: 0.20-0.66). CONCLUSION Methylene blue can relieve pain after anorectal operation and decrease the incidence of postoperative complication. However further studies of higher quality are needed to explore the clinical practical value of methylene blue.
