目的 系統(tǒng)評價(jià)泮托拉唑?qū)Ρ菻2受體拮抗劑預(yù)防術(shù)后應(yīng)激性潰瘍的有效性和安全性，為臨床提供循證參考。方法 計(jì)算機(jī)檢索PubMed、EmBase、Cochrane Library、Clinicaltrials.gov、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）和萬方數(shù)據(jù)庫，收集泮托拉唑（試驗(yàn)組）對比H2受體拮抗劑（對照組）預(yù)防術(shù)后應(yīng)激性潰瘍的臨床隨機(jī)對照試驗(yàn)（RCT），提取資料后，采用Rev Man 5.3統(tǒng)計(jì)軟件進(jìn)行Meta-分析。結(jié)果 共納入14項(xiàng)RCT，共計(jì)1 066例患者。Meta-分析結(jié)果顯示：與對照組相比，試驗(yàn)組應(yīng)激性潰瘍出血（SUB）率顯著降低，差異有統(tǒng)計(jì)學(xué)意義[OR=0.15，95% CI（0.10，0.23），P<0.000 01]；試驗(yàn)組不良反應(yīng)發(fā)生率低于對照組，差異有統(tǒng)計(jì)學(xué)意義[OR=0.12，95% CI（0.03，0.53），P=0.005]。亞組分析顯示術(shù)前給藥的研究SUB發(fā)生率（OR=0.12）低于術(shù)后給藥的（OR=0.21）；預(yù)防療程≤ 7 d的研究SUB發(fā)生率（OR=0.15）與療程>7 d的（OR=0.14）相當(dāng)。結(jié)論 與H2受體拮抗劑相比，泮托拉唑在預(yù)防術(shù)后應(yīng)激性潰瘍時(shí)能顯著降低應(yīng)激性潰瘍出血率，且不良反應(yīng)發(fā)生率更低。

Objective To evaluate effectiveness and safety of pantoprazole versus H2 receptor antagonist for the prevention of postoperative stress ulce, and to provide evidence-based reference in clinic. Methods Retrieved from PubMed, EmBase, Cochrane Library, Clinicaltrials.gov, CNKI, Wanfang datebase and CBM, randomized controlled trials (RCT) about pantoprazole (trial group) versus H2 receptor antagonist (control group) for the prevention of postoperative stress ulce were collected. Meta-analysis was conducted by RevMan 5.3 software after data extraction. Results A total of 14 RCT were inclued, involving 1 106 patients. Metaanalysis showed, the incidences of SUB[OR=0.15, 95% CI(0.10, 0.23), P<0.000 01] and the incidences of ADR[OR=0.12, 95% CI (0.03, 0.53), P=0.005] in trial group were significantly lower than control group, with statistical significance. Results of subgroup analysis showed, the incidences of SUB in preoperative adminiatration (OR=0.12) was lower than postoperative adminiatration (OR=0.21). The incidences of SUB between the course of less than 7 days (contain 7days) (OR=0.15) and more than 7 days (OR=0.14) were similar. Conclusion s The incidences of SUB and ADR of pantoprazole were significantly lower than that of H2 receptor antagonist for the prevention of postoperative stress ulce.

河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題計(jì)劃（20181292）