Network meta-analysis of the effectiveness and safety of 3 kinds of snake venom hemocoagulase drugs for hemostasis in abdominal surgery

ZHENG Zihui; PAN Huijie; ZHAO Zinan; HU Xin; JIN Pengfei

doi:10.6039/j.issn.1001-0408.2023.21.11

您当前的位置：

首页 >

文章列表页 >

Network meta-analysis of the effectiveness and safety of 3 kinds of snake venom hemocoagulase drugs for hemostasis in abdominal surgery

更新时间：2023-11-10

- Network meta-analysis of the effectiveness and safety of 3 kinds of snake venom hemocoagulase drugs for hemostasis in abdominal surgery
- ZHONGGUO YAOFANG Vol. 34, Issue 21, Pages: 2631-2637(2023)
- 作者机构：
  
  1.北京医院药学部/国家老年医学中心/中国医学科学院老年医学研究院/北京市药物临床风险与个体化应用评价重点实验室（北京医院），北京　100730
  2.北京医院检验科/国家老年医学中心/中国医学科学院老年医学研究院，北京　100730
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.21.11
  CLC： R973+.2;R982
- Published：15 November 2023，
  
  Received：08 June 2023，
  
  Revised：04 September 2023，
扫描看全文
郑子恢,潘慧杰,赵紫楠等.3种蛇毒血凝酶类药物用于腹部手术止血有效性和安全性的网状Meta分析 ^Δ[J].中国药房,2023,34(21):2631-2637.

ZHENG Zihui,PAN Huijie,ZHAO Zinan,et al.Network meta-analysis of the effectiveness and safety of 3 kinds of snake venom hemocoagulase drugs for hemostasis in abdominal surgery[J].ZHONGGUO YAOFANG,2023,34(21):2631-2637.
郑子恢,潘慧杰,赵紫楠等.3种蛇毒血凝酶类药物用于腹部手术止血有效性和安全性的网状Meta分析 ^Δ[J].中国药房,2023,34(21):2631-2637. DOI： 10.6039/j.issn.1001-0408.2023.21.11.

ZHENG Zihui,PAN Huijie,ZHAO Zinan,et al.Network meta-analysis of the effectiveness and safety of 3 kinds of snake venom hemocoagulase drugs for hemostasis in abdominal surgery[J].ZHONGGUO YAOFANG,2023,34(21):2631-2637. DOI： 10.6039/j.issn.1001-0408.2023.21.11.

摘要

目的

系统评价3种蛇毒血凝酶类药物用于腹部手术止血的效果及安全性，为临床用药提供循证依据。

方法

计算机检索Embase、Cochrane Library、PubMed、中国生物医学文献数据库、中国知网及万方数据库，收集3种蛇毒血凝酶类药物（蛇毒血凝酶注射液、注射用矛头蝮蛇血凝酶、注射用尖吻蝮蛇血凝酶）在腹部手术的随机对照试验（RCT），检索时限均为建库至2023年8月。按纳入排除标准对文献进行筛选、质量评价及数据提取，使用Cochrane 5.1手册进行文献质量评价。采用Stata 15.1软件绘制风险偏倚图及网状图，应用R 3.6.2软件以及马尔科夫链-蒙特卡洛方法进行贝叶斯网状Meta分析。

结果

共纳入11项研究，合计1 401例患者，试验组852例、对照组549例。在腹部手术止血效果方面，蛇毒血凝酶注射液明显优于注射用尖吻蝮蛇血凝酶[MD＝－2.45，95%CI（－4.39，－0.24），

＜0.05]，减少术中出血量概率排序为蛇毒血凝酶注射液＞注射用矛头蝮蛇血凝酶＞注射用尖吻蝮蛇血凝酶；在安全性方面，3种蛇毒血凝酶类药物与安慰剂相比差异均无统计学意义（

＞0.05）。

结论

蛇毒血凝酶注射液在腹部手术中止血效果明显优于注射用尖吻蝮蛇血凝酶，3种蛇毒血凝酶类药物安全性均良好。

Abstract

OBJECTIVE

To systematically evaluate the hemostatic effect and safety of snake venom hemocoagulase drugs in abdominal surgery， so as to provide evidence-based evidence for clinic.

METHODS

Retrieved from Embase， Cochrane Library， PubMed， China Biomedical Literature Database， CNKI and Wanfang database， randomized controlled trials （RCTs） about 3 kinds of snake venom hemocoagulase drugs （Hemocoagulase injection，

Hemocoagulase

Bothrops atrox

for injection， Haemocoagulase

Agkistrodon

for injection） in abdominal surgery were collected from the establishment of the database to Aug. 2023. Screening， quality evaluation， and data extraction were conducted on literature according to the inclusion and exclusion criteria， and Cochrane 5.1 was used for literature quality evaluation. The risk bias diagram and network diagram were drawn by Stata 15.1 software， and the Bayesian network meta-analysis was carried out by using R 3.6.2 software and Markov chain-Monte Carlo method.

RESULTS

A total of 11 studies were included， involving 1 401 patients， 852 in the study group， and 549 in the control group. In terms of hemostatic effect， Hemocoagulase injection was significantly superior to Haemocoagulase

Agkistrodon

for injection [MD＝－2.45， 95%CI （－4.39，－0.24），

＜0.05]， and the probability of reducing intraoperative bleeding was

ranked as follows： Hemocoagulase injection＞hemocoagulase

B. atrox

for injection＞Haemocoagulase

Agkistrodon

for injection； in terms of safety， there was no statistically significant difference between the three snake venom hemocoagulase drugs and placebo （

＞0.05）.

CONCLUSIONS

The hemostatic effect of Hemocoagulase injection in abdominal surgery is significantly better than that of Haemocoagulase

Agkistrodon

for injection； all three snake venom hemocoagulase drugs have good safety.

关键词

蛇毒血凝酶类药物腹部手术止血有效性安全性贝叶斯网状Meta分析

Keywords

abdominal surgeryhemostaticeffectivenesssafetyBayesian network meta-analysis

references

昝昕，胡鑫，王婕，等. 出凝血功能障碍相关性脑出血中国多学科诊治指南[J]. 中国急救医学，2021，41（8）：647-660.

ZAN X，HU X，WANG J，et al. Guidelines for multidisciplinary diagnosis and treatment of cerebral hemorrhage associated with bleeding and coagulation dysfunction in China[J]. Chin J Crit Care Med，2021，41（8）：647-660.

中华医学会神经外科学分会.神经外科围手术期出血防治专家共识：2018[J].中华医学杂志，2018，98（7）：483-495.

Chinese Society of Neurosurgery. Expert consensus on prevention and treatment of perioperative hemorrhage in neurosurgery ：2018 [J]. Natl Med J China，2018，98（7）：483-495.

中国医师协会脑胶质瘤专业委员会.中国神经外科术后加速康复外科（ERAS）专家共识[J].中华神经外科杂志，2020，36（10）：973-983.

Glioma Committee of Chinese Medical Doctor Association. Expert consensus on Enhanced Recovery After Surgery （ERAS） in neurosurgery in China[J]. Chin J Neurosurg，2020，36（10）：973-983.

金发光.大咯血诊疗规范[J].中华肺部疾病杂志（电子版），2019，12（1）：1-8[2023-05-10]. https：//kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C44YLTlOAiTRKibYlV5Vjs7iLik5jEcCI09uHa3oBxtWoC6lw-VODQWI5-ycX1fcKKiC6EfADP_SEEo64WSrtTrG-&uniplatform=NZKPT. DOI：10.3877/cma.j.issn.1674-6902.2019.01.001https://kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C44YLTlOAiTRKibYlV5Vjs7iLik5jEcCI09uHa3oBxtWoC6lw-VODQWI5-ycX1fcKKiC6EfADP_SEEo64WSrtTrG-&uniplatform=NZKPT.DOI:10.3877/cma.j.issn.1674-6902.2019.01.001.

JIN F G. Standard for diagnosis and treatment of massive hemoptysis[J]. Chin J Lung Dis（Electronic），2019，12（1）：1-8[2023-05-10]. https：//kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C44YLTlOAiTRKibYlV5Vjs7iLik5-jEcCI09uHa3oBxtWoC6lw-VODQWI5ycX1fcKKiC6Ef-ADP_SEEo64WSrtTrG-&uniplatform=NZKPT. DOI：10.3877 /cma.j.issn.1674-6902.2019.01.001https://kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C44YLTlOAiTRKibYlV5Vjs7iLik5-jEcCI09uHa3oBxtWoC6lw-VODQWI5ycX1fcKKiC6Ef-ADP_SEEo64WSrtTrG-&uniplatform=NZKPT.DOI:10.3877/cma.j.issn.1674-6902.2019.01.001.

齐榛，郭代红，姚翀，等. 399例蛇毒类血凝酶相关药品不良反应报告分析及风险信号挖掘[J]. 中国药物应用与监测，2019，16（5）：278-282.

QI Z，GUO D H，YAO C，et al. The analysis of 399 ADRs associated with hemocoagulase and the risk signals mining[J]. Chin J Drug Appl Monit，2019，16（5）：278-282.

姚翀，郭代红，王辰允，等. 32 203例注射用尖吻蝮蛇血凝酶相关变态反应自动监测研究[J]. 中国临床药理学杂志，2020，36（3）：346-350.

YAO C，GUO D H，WANG C Y，et al. Incidence and risk factors of allergic reaction related by haemocoagulase Agkistrodon for injection among 32 203 patients by automatic surveillance[J]. Chin J Clin Pharmacol，2020，36（3）：346-350.

WEI J M，ZHU M W，ZHANG Z T，et al. A multicenter，phase Ⅲ trial of hemocoagulase Agkistrodon：hemostasis，coagulation，and safety in patients undergoing abdominal surgery[J]. Chin Med J，2010，123（5）：589-593.

欧光武，李威. 尖吻蝮蛇凝血酶对手术切口止血有效性及安全性的临床研究[J]. 现代生物医学进展，2010，10（2）：274-276.

OU G W，LI W. A clinical research of hemocoagulase acutus on hemostatic effectiveness of wound and hemoagglutination safety in operation[J]. Prog Mod Biomed，2010，10（2）：274-276.

韦军民，朱明炜，张忠涛，等. 尖吻蝮蛇血凝酶对腹部手术切口止血作用的有效性和安全性[J]. 中国新药杂志，2007，16（14）：1126-1129.

WEI J M，ZHU M W，ZHANG Z T，et al. The effects of hemocoagulase Agkistrodon on its hemostatic and hemoagglutinant function，on abdominal incision and safety in surgical patients，a multicenter clinical study[J]. Chin J N Drugs，2007，16（14）：1126-1129.

谢舜峰，杨填，孙淑明，等. 尖吻蝮蛇凝血酶对腹部手术切口止血的有效性及安全性临床研究[J]. 中国医药，2010，5（6）：545-547.

XIE S F，YANG T，SUN S M，et al. A clinical study of haemocoagulase acutus on wound hemostasis in abdominal operation[J]. China Med，2010，5（6）：545-547.

张房伯. 蛇毒血凝酶在腹部手术中的应用研究[J]. 实用心脑肺血管病杂志，2011，19（3）：443-444.

ZHANG F B. Study on the application of snake venom hemagglutination enzyme in abdominal surgery[J]. Pract J Card Cereb Pneumal Vasc Dis，2011，19（3）：443-444.

朱明炜，曹金铎，贾振庚，等. 蛇毒血凝酶在腹部手术中止血作用以及对凝血功能的影响[J]. 中华外科杂志，2002，40（8）：581-584.

ZHU M W，CAO J D，JIA Z G，et al. Hemocoagulase in abdominal operation and its effect on hemoagglutination[J]. Chin J Surg，2002，40（8）：581-584.

朱延安，金剑英，张法标，等.蛇毒血凝酶注射液对老年外科止血的临床效果探讨[J].中国生化药物杂志，2014，34（3）：100-102.

ZHU Y A，JIN J Y，ZHANG F B，et al. Clinical study on hemostatic of reptilase in elderly surgery bleeding[J]. Chin J Biochem Pharm，2014，34（3）：100-102.

胡俊峰，孙元水. 注射用血凝酶在腹腔镜胃癌根治术中止血作用的临床研究[J]. 实用肿瘤杂志，2014，29（4）：378-380.

HU J F，SUN Y S. Administration of hemocoagulase in laparoscopic radical gastrectomy for gastric cancer[J]. J Pract Oncol，2014，29（4）：378-380.

周俊杰，黄宗海，俞金龙，等. 注射用尖吻蝮蛇凝血酶Ⅱa期临床应用研究[J]. 南方医科大学学报，2007，27（5）：644-646.

ZHOU J J，HUANG Z H，YU J L，et al. Phase Ⅱa clinical trial of hemocoagulase acutus for injection[J]. J South Med Univ，2007，27（5）：644-646.

董虹亮，刘蓉，夏冬. 巴曲亭对结肠癌手术患者160例止血效果观察[J]. 现代预防医学，2009，36（20）：3993-3994，4001.

DONG H L，LIU R，XIA D. Clinical investigation on hemostatic effect of hemocoagulase in 160 patients with colon carcinoma in peroperative period[J]. Mod Prev Med，2009，36（20）：3993-3994，4001.

陈琨，张春. 速乐涓在宫颈Leep刀手术中止血效果的临床观察[J]. 中国妇幼保健，2008，23（34）：4913-4914.

CHEN K，ZHANG C. Clinical observation on hemostasis effect of Sulejuan in cervical Leep knife operation[J]. Matern Child Health Care China，2008，23（34）：4913-4914.

古德华，卢承志，吴江. 矛头蝮蛇血凝酶诱发支气管痉挛1例[J]. 人民军医，2016，59（12）：1234.

GU D H，LU C Z，WU J. A case of bronchospasm induced by hemocoagulase from Agkistrodon halys[J]. People’s Mil Surg，2016，59（12）：1234.

赵珊珊，李静. 注射用蛇毒类血凝酶制剂的不良反应文献分析[J]. 中国医院药学杂志，2015，35（24）：2227-2230.

ZHAO S S，LI J. Literatures analysis of adverse drug reactions induced by snake venom hemocoagulase injection[J]. Chin J Hosp Pharm，2015，35（24）：2227-2230.

张英，苏婷婷，邱源旺，等. 白眉蛇毒血凝酶治疗食管胃静脉曲张破裂出血致严重低纤维蛋白原血症的相关因素[J]. 中国中西医结合消化杂志，2019，27（1）：58-61，66.

ZHANG Y，SU T T，QIU Y W，et al. Factors related to severe hypofibrinogenemia caused by hemocoagulase in patients with esophageal and gastric variceal bleeding[J]. Chin J Integr Tradit West Med Dig，2019，27（1）：58-61，66.

闫圣涛，张国强.血凝酶在急性出血性疾病中应用的专家共识[J].中华急诊医学杂志，2018，27（2）：137-140.

YAN S T，ZHANG G Q. Expert consensus on the application of hemocoagulase enzyme in acute hemorrhagic diseases[J]. Chin J Emerg Med，2018，27（2）：137-140.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Efficacy and safety comparison of lacosamide and carbamazepine in the treatment of adult patients with newly diagnosed epilepsy

Meta-analysis of efficacy and safety of cabozantinib in the treatment of advanced thyroid cancer

Efficacy and safety of aerosol inhalation of polycolistin B in patients with severe pneumonia combined with mechanical ventilation

Rapid health technology assessment of baloxavir marboxil in the treatment of influenza

Rapid health technology assessment of linaclotide in the treatment of constipated irritable bowel syndrome

Related Author

GUO Xiaqing

LI Guofei

SUN Yuhua

ZHENG Donglin

ZHU Jing

XIE Ji

ZHAO Ziting

HU Xiaoxia

Related Institution

First Ward， Dept. of Neurology， Huaihe Hospital of Henan University

Dept. of Oncology， Lanzhou University Second Hospital

Dept. of Geriatrics， Lanzhou University Second Hospital

Center for Big Data Research in Health and Medicine， the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital

Dept. of Clinical Pharmacy， the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital， Shandong Engineering and Technology Research Center for Pediatric Drug Development， Shandong Medicine and Health Key Laboratory of Clinical Pharmacy

Address：8/F,129 Daping Main Street,Yuzhong District,Chongqing 400042,P.R.China
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰