肝手术中特利加压素输注的疗效和安全性:一项荟萃分析。

IF 2.4 3区 医学 Q2 SURGERY
Lin Ding, Yi Duan, Zuozhi Li, Qiyue Wu, Lan Yao, Zhifeng Gao
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引用次数: 0

摘要

尽管许多研究已经调查了特利加压素(TP)在肝脏手术中的应用以减轻出血,但其疗效仍存在争议。本荟萃分析评估了TP对估计失血量(EBL)、输血需求和患者预后的影响。我们系统地检索了PubMed、EMBASE、Cochrane Library和Web of Science (WOS),从它们成立到2024年2月,关于肝手术围手术期TP使用的研究。只包括英文出版物。主要结局包括EBL和异基因输血量。纳入了12项研究,涉及988名符合条件的受试者。EBL无显著差异(加权平均差[WMD] = - 99.09;95%置信区间[CI], - 318.41 ~ 120.24;P = 0.38),红细胞(RBC)输血量(标准化平均差[SMD] = - 0.10;95% CI = - 0.74 ~ 0.54;P = 0.76)或新鲜冷冻血浆(FFP)输血量(SMD = 0.07;95% CI = - 0.24 ~ 0.37;p = 0.67)。亚组分析显示,持续TP输注显著降低术中EBL (WMD = - 336.22;95% CI = - 562.13 ~ - 110.31;p = 0.004)。TP输注不能减少术中EBL或肝脏手术中异体输血需求。然而,持续输注TP可降低EBL。普洛斯彼罗注册号:CRD42023450333。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy and safety of terlipressin infusion during liver surgery: a meta-analysis.

Although numerous studies have investigated terlipressin (TP) administration in liver surgery to mitigate bleeding, its efficacy remains controversial. This meta-analysis evaluates the effects of TP on estimated blood loss (EBL), blood transfusion requirements, and patient outcomes. We systematically searched PubMed, EMBASE, Cochrane Library, and Web of Science (WOS) for studies on perioperative TP use in liver surgery from their inception through February 2024. Only English-language publications were included. Primary outcomes included EBL and allogeneic blood transfusion volume. Twelve studies involving 988 eligible subjects were included. No significant differences were observed in EBL (weighted mean difference [WMD] =  - 99.09; 95% confidence interval [CI], - 318.41 to 120.24; P = 0.38), red blood cell (RBC) transfusion volume (standardized mean difference [SMD] =  - 0.10; 95% CI =  - 0.74 to 0.54; P = 0.76), or fresh frozen plasma (FFP) transfusion volume (SMD = 0.07; 95% CI =  - 0.24 to 0.37; P = 0.67). Subgroup analysis demonstrated that continuous TP infusion significantly reduced intraoperative EBL (WMD =  - 336.22; 95% CI =  - 562.13 to - 110.31; P = 0.004). TP infusion does not reduce intraoperative EBL or allogeneic blood transfusion requirements in liver surgery. However, continuous TP infusion may lower EBL.PROSPERO registration number: CRD42023450333.

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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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