中文摘要：

目的采用Meta分析比较5一羟色胺（5-hydroxytryptamine，5_HL）受体拮抗剂与氟哌利多预防术后恶心呕吐（postoperativenauseaandvomiting，PONV）的效果。方法检索Cochrane图书馆、Pubmed、EMBASE、中国生物医学文献数据库（CBM）、中国学术期刊全文数据库（CNKI）、重庆维普中文科技期刊全文数据库（VIP）、万方数据库，检索时间从建库至2013年9月。收集所有比较5_HTl受体拮抗剂与氟哌利多用于预防全麻PONV的文献。采用Cochrane协作网系统评价法评价纳入文献的质量，采用RevMan5．1软件对收集的患者资料进行Meta分析评价。结果共纳入17项随机对照试验（randomizedcontrolledtrial，RCT），1823例患者。Meta分析结果显示：与氟哌利多比较，5-HT3受体拮抗剂能降低全麻患者PONV（术后0～24h）[比值比（RR）：0．49，95％可信区间（CI）=0．39—0．63]与呕吐（RR=0．54，95％CI=0．43～0．67）的发生率。亚组分析结果表明，昂丹司琼预防PONV（RR=0．67，95％CI=0．47—0．96）与呕吐（RR=0．56，95％CI=0．39～0．82）的发生较氟哌利多更好；格拉司琼预防PONV（RR=0．42，95％CI=0．30～0．58）与呕吐（RR=0．58，95％CI=0．42～0．81）的发生较氟哌利多更好。5-HT，受体拮抗剂与氟哌利多预防术后恶心的效果相当（RR=O．89，95％CI=0．77—1．04）。昂丹司琼（RR=0．88，95％CI=0．67～1．14）或格拉司琼（RR=0．94，95％CI=0．75—1．17）与氟哌利多预防术后恶心的效果相当。与氟哌利多比较较，5-HT，受体拮抗剂组头痛发生率明显增加（RR=1．44，95％CI=I．12—1．84）；5-HT]受体拮抗剂与氟哌利多术后头晕（RR=I．19，95％CI=0．88～1．62）、嗜睡（RR=1．24，95％CI=0．34～4．49）的发生率相同。结论与氟哌利多比较，5-HT3拮抗剂预防全麻患者PONV效果较好。

英文摘要：

Objective To systematically review the efficacy of 5-hydroxytryptamine （5-HT3） receptor antagonist and droperidol for prevention of postoperative nausea and vomiting （PONY）. Methods We searched the PubMed, EMBase, Cochrane library, Wanfang Database, CNK1, VIP and Chinese Biomedical Datebase for all randomized controlled trials about the efficacy of 5- HT3 receptor antagonist versus droperidol for prevention of PONY after general anesthesia. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration＇s RevMan 5.1 software. Results A total of 17 randomized controlled trials involving 1 823 patients were included. Compared with droperidol, the incidence of PONY （RR=0.49, 95%CI=0.39-0.63） and vomiting （RR--0.54, 95%CI=0.43-0.67） in the 5-HT3 receptor antagonist group was lower. Ondansetron is more effective than droperidol in reducing PONY （RR=0.48, 95%CI=0.25-0.92 or vomiting （RR= 0.48, 95%CI=0.30-0.77）, granisetron is more effective than droperidol in reducing PONV（RR=0.27,95%CI=0.17-0.438 ） or vomiting （RR=0.47, 95%CI=0.30-0.74）. 5-HT3 receptor antagonist group was no more effective than droperidol for prevention of nausea（RR= 0.89,95% CI =0.77 - 1.04）, ondansetron （ RR =0.80,95% CI =0.5Z-1.24）or granisetron （ RR =0.90,95% CI =0.63 -1.28 ） could not significantly lessen the incidence of nausea compared with droperidol. Compared with droperidol, the incidence of headache （RR= 1.44,95%CI=1.12-1.84） in 5-HT3 receptor antagonist group was higher,there were no significant changes in the incidence of dizziness （RR=1.19,95%CI=0.88-1.62） and drowsiness （RR=1.24,95%CI=0.34-4.49）. Conclusions The efficacy of 5-HT3 receptor antagonist is better than droperidol in the prevention of PONY after general anesthesia.