新鲜冷冻血浆治疗急性有机磷中毒患者的有效性:最新的系统综述和荟萃分析

Asia Pacific Journal of Medical Toxicology Pub Date : 2019-09-01 DOI:10.22038/APJMT.2019.13826

O. Nafea, M. Aziz, Fatma Saptan, A. R. Abdalla, H. Ibrahim

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引用次数: 2

摘要

背景：有机磷（OP）中毒仍然是发达国家和发展中国家的主要健康问题。（OP）中毒的标准治疗方法并不总是可用的，因此它们可能显示出有限的成功率。新鲜冷冻血浆（FFP）是一种生物清除剂，已被认为是一种通过消除游离有机磷而有效的治疗方法。因此，本系统综述和荟萃分析旨在更新有关FFP治疗急性OP中毒患者疗效的现有证据。方法：检索PubMed和Scopus的计算机文献，确定相关的随机对照试验（RCT）。此外，还对检索到的文章的参考文献列表进行了手动检索。RevMan 5.3版Windows版将相关结果汇总为平均差（MD）风险比（RR）。结果：来自3项随机对照试验（169名患者）的汇总数据显示，在急性OP中毒患者的常规治疗中添加FFP并不能改善阿托品总量（MD=35.05，95%CI=[4.14-111.24]，P值=0.37）和解磷定剂量（MD=0.41，95%CI=[2.34-1.51]，P值0.67）的临床结果，住院时间（MD=2.08，95%CI=[4.51至0.35]，P值=0.09）和死亡率（RR=0.42，95%CI=[0.14至1.27]，P价值=0.12）。结论：与常规治疗相比，新鲜冷冻血浆对急性OP中毒患者没有任何额外的益处。纳入试验的数量和规模有限是造成这种影响的最可能原因。

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Effectiveness of Fresh Frozen Plasma in Management of Acute Organophosphate Intoxicated Patients: An Updated Systematic Review and Meta-Analysis

Background:Organophosphate (OP) poisoning is still a major health concern in both developed and developing countries. The standard treatment approaches of (OP) poisoning are not always available as well so they may show a limited success rate. Fresh frozen plasma (FFP) is one of Bio-scavengers that have been suggested as a useful therapy through elimination of free organophosphates. Therefore, this systematic review and meta-analysis was conducted to update the present evidence about the efficacy of FFP in management of acute OP-intoxicated patients. Method:A computer literature search of PubMed and Scopus was conducted to identify the relevant randomized controlled trials (RCTs). In addition, a manual search of reference lists of the retrieved articles was conducted. Relevant outcomes were pooled as mean difference (MD) risk ratio (RR) by RevMan version 5.3 for Windows. Results:Pooled data from 3 RCTs (169 patients) showed that adding FFP to conventional therapy to acutely OP intoxicated patients did not improve clinical outcomes regarding total atropine (MD = 35.05, 95% CI = [-41.14 to 111.24], P-value = 0.37) and pralidoxime dosages (MD = -0.41, 95% CI = [-2.34 to 1.51], P-value = 0.67), length of hospital stay (MD = -2.08, 95% CI = [-4.51 to 0.35], P-value = 0.09) and mortality (RR = 0.42, 95% CI = [0.14 to 1.27], P-value = 0.12). Conclusion: Fresh frozen plasma did not provide any additional benefit in acutely-OP intoxicated patients compared to the conventional therapy. The limited number and sizes of the included trials are the most probable cause of such effects.

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来源期刊

Asia Pacific Journal of Medical Toxicology

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： Asia Pacific Journal of Medical Toxicology (APJMT) aims to expand the knowledge of medical toxicology and tries to provide reliable information in this field for medical and healthcare professionals. APJMT mainly focuses on research related to medical toxicology issues in the Asia Pacific region and publishes articles on clinical and epidemiological aspects of toxicology, poisonings emergency care, addiction, drug interactions and adverse effects. The journal accepts and welcomes high quality papers in the form of original articles and rarely review articles, case reports and scientific letters relevant to medical practice in toxicology.