目的 比较瑞马唑仑与丙泊酚用于无痛逆行胰胆管造影术（ERCP）诊疗中的安全性。 方法 计算机检索PubMed、Cochrane Library、Embase、Ovid、Web of Science、Springerlink、万方数据库、中国知网数据库，检索日期为建库至2023年5月，纳入研究组为瑞马唑仑、对照组为丙泊酚应用于无痛ERCP诊疗中的随机对照试验。从符合纳入及剔除标准的文献中提取数据，同时采用Review Manager 5.4和Stata统计学软件进行分析。 结果 共纳入11篇随机对照研究，共计1339例患者。瑞马唑仑组672例，丙泊酚组667例。Meta分析结果显示，与丙泊酚组比较，瑞马唑仑组注射痛（OR=0.01，95%CI:0.01 to 0.05,P 0.00001),低血压（OR=0.31,95%CI:0.23 to 0.43,P 0.00001）,低氧血症（OR=0.36，95%CI:0.24 to 0.54，P 0.00001）,窦性心动过缓 （OR=0.33，95%CI:0.20 to 0.54，P 0.0001）,呼吸抑制( OR=0.24，95%CI:0.09 to 0.64，P =0.004)发生率明显降低, 恶心呕吐(OR=0.73，95%CI:0.43 to 1.23，P =0.24),诱导时间（MD=-3.12，95%CI:-11.38 to 5.14，P =0.46）, 苏醒时间（MD=-1，95%CI: -4.43 to 2.42 ，P =0.57),头晕(OR=0.42，95%CI:0.12 to 1.45，P =0.17),呛咳(OR=0.46，95%CI:0.06 to 3.68，P =0.47)，睁眼时间(MD=-1.50，95%CI: -3.17 to 0.16，P =0.08)差异无统计学意义。结论 与丙泊酚比较，瑞马唑仑用于无痛ERCP诊疗时血流动力学更稳定，注射痛、呼吸抑制等不良事件的发生率明显降低，恶心呕吐、诱导时间和苏醒时间方面无明显差异。
Objective To compare the safety of remimazolam and propofol in patients undergoing painless endoscopic retrograde cholangiopancreatography (ERCP)procedure. Methods PubMed,Cochrane Library,Embase database,Ovid,Web of Science,Springerlink,Wanfang Data Knowledge Service Platform,China Knowledge Network were searched from the creation of the database to May 2024,and patients undergoing painless ERCP procedure were included into the experimental group of remazolam and the control group with propofol in a randomized controlled trial.The literature was carefully reviewed to identify data that met the inclusion and exclusion criteria.The extracted data were analyzed using Review Manager 5.4 and Stata 16 statistical software.Results Eleven trials with a total of 1339 patients were included. A total of 672 patients underwent remazolam and 667 patients were injected propofol.The Meta analysis showed that the incidence of injection pain（OR=0.01，95%CI:0.01 to 0.05,P 0.00001),hypotension（OR=0.31,95%CI:0.23 to 0.43,P 0.00001）,hypoxemia（OR=0.36，95%CI:0.24 to 0.54，P 0.00001）,bradycardia （OR=0.33，95%CI:0.20 to 0.54，P 0.0001）,respiratory depression ( OR=0.24，95%CI:0.09 to 0.64，P =0.004)were significantly reduced,but nausea and vomiting(OR=0.73，95%CI:0.43 to 1.23，P =0.24),induction time（MD=-3.12，95%CI:-11.38 to 5.14，P =0.46）, recovery time（MD=-1，95%CI: -4.43 to 2.42 ，P =0.57),dizziness(OR=0.42，95%CI:0.12 to 1.45，P =0.17),cough(OR=0.46，95%CI:0.06 to 3.68，P =0.47)and awaken time（MD=-1.50，95%CI: -3.17 to 0.16，P =0.08) had no significant diffeerences. Conclusion Compared with propofol, remazolam is more haemodynamicaly stable when using painless ERCP procedure in patients, with a significantly lower incidence of adverse events such as injection pain and respiratory depression,but there are no significant differences in nausea and vomiting,induction time and awaken time
Cited
)
