目的 評價(jià)持續(xù)靜脈滴注奧美拉唑治療上消化道出血的療效及安全性。方法 檢索PubMed、EMbase、Cochrane系統(tǒng)評價(jià)數(shù)據(jù)庫（CDSR）、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）和維普中文科技期刊數(shù)據(jù)庫（VIP）數(shù)據(jù)庫，檢索時(shí)限2000年1月－2017年12月。收集持續(xù)靜脈滴注奧美拉唑與間歇靜脈滴注奧美拉唑治療上消化道出血的隨機(jī)對照試驗(yàn)（RCT）文獻(xiàn)，采用Rev Man 5.2軟件進(jìn)行Meta分析。結(jié)果 納入16篇RCT，共2 683例患者進(jìn)行Meta分析。結(jié)果顯示：持續(xù)靜脈滴注奧美拉唑與對照組（間歇靜脈滴注奧美拉唑）比較，持續(xù)靜脈滴注組的顯效率［OR=2.24，95% CI（1.67～3.00），Z=5.43］，總有效率［OR=2.42，95% CI（1.61～3.62），Z=4.28］，平均輸血量［MD=-0.80，95% CI（-1.01～-0.59），Z=7.33］，差異均有統(tǒng)計(jì)學(xué)意義（P<0.01）；再出血率［OR=0.56，95% CI（0.29～1.07），Z=1.75］，差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 持續(xù)靜脈滴注奧美拉唑治療上消化道出血的療效優(yōu)于間歇靜脈滴注，但受納入文獻(xiàn)質(zhì)量的影響，以上結(jié)論需要高質(zhì)量的臨床證據(jù)進(jìn)一步證實(shí)。

Objective To evaluate the clinical efficacy and safety of continuous intravenous infusion of omeprazole in patients with upper gastrointestinal bleeding. Methods Databases including PubMed, Embase, Cochrane Database of Systematic Reviews (CDSR), CNKI, and VIP were searched to collect randomized controlled trials (RCTs) about continuous intravenous versus intermittent intravenous infusion of omeprazole in the treatment of upper gastrointestinal hemorrhage from January 2000 to December 2017. Meta-analysis was conducted by RevMan 5.2 software. Results A total of 2 683 patients involved in 16 RCTs were searched. Meta-analysis showed that according to cure rates[OR=2.24, 95%CI (1.67-3.00), Z=5.43, P<0.01], the total effective rates[OR=2.42, 95%CI (1.61-3.62), Z=4.28, P<0.01], and the average transfusion volume[MD=-0.80, 95%CI (-1.01- -0.59), Z=7.33, P<0.01] in the continuous intravenous infusion group, significant differences were noted between the continuous intravenous infusion of omeprazole group and the control group (intermittent intravenous infusion of omeprazole). There was no statistical significance between the two groups in the rebleeding rates[OR=0.56, 95%CI (0.29-1.07), Z=1.75, P=0.08]. Conclusion The current domestic evidence suggests that the clinical effect continuous intravenous infusion of omeprazole is better than that of control group. However, because of the low quality of the included trials, the above conclusion needs to be further confirmed based on high-quality evidence in clinic.

湖北省衛(wèi)生計(jì)生科研基金項(xiàng)目（WJ2015MB290）；十堰市科學(xué)技術(shù)研究與開發(fā)計(jì)劃項(xiàng)目（16Y60）