| 滑石粉和博来霉素治疗恶性胸腔积液的系统评价 |
| Alternative Title | A systematic review of talc compared with bleomycin for patient with malignant pleural effusion
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| 魏永罡 |
| Thesis Advisor | 余勤
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| 2009-05-24
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 滑石粉
博来霉素
恶性胸腔积液
系统评价
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| Abstract | 目的：胸腔积液是晚期恶性肿瘤常见的并发症，约50％的肿瘤转移患者有恶性胸腔积液，滑石粉、博来霉素、四环素是胸膜固定术中应用最多的药物，本研究系统评价滑石粉和博来霉素治疗恶性胸腔积液的有效性和不良反应。
方法：计算机检索PubMed、Embase、Cochrane Library、CBM、CNKI、维普数据库，手工检索相关领域的杂志，同时从纳入文献或相关综述、系统评价的参考文献中追溯查找。按照纳入标准，全面搜集有关滑石粉和博来霉素治疗恶性胸腔积液的的随机对照试验，由至少两位评价员做独立文献筛查、质量评价和资料提取，并交叉核对，不同意见请第三者裁决。使用RevMan5.0软件进行统计分析。
结果：6篇随机对照试验研究纳入分析，共224例研究对象。4篇文献质量B级，2篇文献质量C级。分析结果表明：滑石粉治疗恶性胸腔积液在有效率[RR=1.22, 95%CI (1.05, 1.42) ]、复发率[RR=0.31, 95%CI (0.11, 0.87 ]方面优于博来霉素，差异有统计学意义。而在病死率[RR=1.39, 95%CI (0.84, 2.30) ]、发热[RR=0.68, 95%CI(0.24, 1.94]、疼痛[RR=0.22, 95%CI(0.01, 4.32]方面二者差异无统计学意义。
结论：当前证据表明滑石粉治疗恶性胸腔积液在提高有效率、减低复发率方面均优于博来霉素，而在病死率、引起发热和疼痛不良反应方面二者无差异。上述结果仍需高质量、大样本多中心的随机对照试验进一步证实。 |
| Other Abstract | Abstract Malignant pleural effusion are a common complication in advanced malignancy. talc, bleomycin and the tetracyclines are the three most frequently used effect. We want to evaluate the efficacy and adverse effect of patients with malignant pleural effusion treated with talc and bleomycin.
Methods We searched PubMed, Embase, The Cochrane Library, Chinese biomedicine literature Database (CBM), CNKI, VIP, reference of included studies for Randomized Controlled Trials comparing talc with bleomycin for patients with malignant pleural effusion. The quality of included studies was assessed independently by two reviewer, discrepancies were resolved by discussion with the third person. We analyzed the Data using Review Manager (version 5.0) software.
Results six studies totaling 224 patients were included. Meta analysis results were as follows: there was significant difference in treatment success [RR=1.22, 95%CI (1.05, 1.42) ]、recurrence rate [RR=0.31, 95%CI (0.11, 0.87 ]between talc group and bleomycin group， there was no significant difference between the two groups in case fatality rate [RR=1.39, 95%CI (0.84, 2.30) ]、fever [RR=0.68, 95%CI (0.24, 1.94]、pain [RR=0.22, 95%CI (0.01, 4.32].
Conclusion Current evidence indicate that talc is super to bleomycin for patients with malignant pleural effusion in terms of improving treatment success and reducing recurrence rate, there is no significant difference between the two group with regard to case fatality rate、fever、pain，the results mentioned above still need to be confirmed by high quality, large sample, multicenter randomized controlled trial. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223325
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
魏永罡. 滑石粉和博来霉素治疗恶性胸腔积液的系统评价[D]. 兰州. 兰州大学,2009.
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