阿片类镇痛药物对患者术后肠道恢复影响的Meta分析

田利; 张宗泽

doi:10.14188/j.1671-8852.2023.0672

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阿片类镇痛药物对患者术后肠道恢复影响的Meta分析

综述与Meta分析 | 更新时间：2026-11-05

- 阿片类镇痛药物对患者术后肠道恢复影响的Meta分析
- Effect of opioid analgesia on postoperative intestinal recovery： A meta⁃analysis
- 武汉大学学报（医学版） 2025年46卷第4期页码：554-560
- 作者机构：
  
  武汉大学中南医院麻醉科湖北武汉 430071
- 作者简介：
  
  田利，女，1997—，医学硕士生，主要从事麻醉与相关并发症的研究，E⁃mail:2021283030207@whu.edu.cn
  张宗泽，男，1964—，医学博士，副教授，博士生导师，主要从事围术期重要器官保护的研究，E⁃mail:Zhangzz@whu.edu.cn
- 基金信息：
- DOI：10.14188/j.1671-8852.2023.0672
  中图分类号： R619⁺.9
- 收稿：2023-12-12，
  
  纸质出版：2025-04-25
- 稿件说明：
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田利,张宗泽.阿片类镇痛药物对患者术后肠道恢复影响的Meta分析[J].武汉大学学报（医学版）,2025,46(04):554-560.

TIAN Li,ZHANG Zongze.Effect of opioid analgesia on postoperative intestinal recovery： A meta⁃analysis[J].Medical Journal of Wuhan University,2025,46(04):554-560.
田利,张宗泽.阿片类镇痛药物对患者术后肠道恢复影响的Meta分析[J].武汉大学学报（医学版）,2025,46(04):554-560. DOI： 10.14188/j.1671-8852.2023.0672.

TIAN Li,ZHANG Zongze.Effect of opioid analgesia on postoperative intestinal recovery： A meta⁃analysis[J].Medical Journal of Wuhan University,2025,46(04):554-560. DOI： 10.14188/j.1671-8852.2023.0672.

摘要

目的

采用Meta分析的方法研究围术期阿片类与非阿片类药物的镇痛方案对术后肠道恢复的影响程度。

方法

检索中国知网、万方、PubMed、Cochrane Library、Embase数据库。检索时限为建库至2023年8月1日。纳入有关围术期使用阿片类镇痛药物、非阿片类镇痛药物或多模式镇痛的随机对照试验。采用RevMan 5.4软件对文献中研究所提供的术后首次排气时间、术后首次排便时间以及术后首次肠鸣音时间这3个指标进行综合定量分析。

结果

最终有9篇文献纳入，总样本量患者数为873人，其中阿片类药物镇痛组为438人，非阿片类药物或多模式镇痛组为435人。Meta分析显示：两组在术后首次排气时间[

WMD

=-16.72，95%

: （-24.76~-8.68），

0.000 1

]

、术后首次排便时间[

WMD

=-36.10，95%

: （-50.81~-21.39），

0.000 01

]

以及术后首次肠鸣音时间[

WMD

=-8.39，95%

: （-9.50~-7.27），

0.000 01

]

这三项指标差异均有统计学意义。

结论

现有的临床文献数据表明，围手术期患者减少使用阿片类药物、采用多模式镇痛可使得肠道排气排便时间缩短，肠鸣音恢复更快，更利于术后肠道恢复。

Abstract

Objective

To evaluate the effects of perioperative opioid and non⁃opioid analgesia on postoperative intestinal recovery by meta⁃analysis.

Methods

Randomized controlled trials (RCTs) about using opioid analgesics vs. non⁃opioid analgesics or multimodal analgesics perioperatively were retrieved in the databases of CNKI

Wanfang data

PubMed

Cochrane Library

and Embase. The published time was set from the establishment of the database to August 1st

2023. The RevMan 5.4 software was used to conduct a comprehensive quantitative analysis of the first time of postoperative exhaust

the first time of postoperative defecation and the time of first bowel sound provided by the research institutes in the literature.

Results

A total of 9 articles were included. There were 873 patients，including 438 in the opioid analgesia group and 435 in the non⁃opioid or multimodal analgesia group. Meta⁃analysis showed that the diffe

rences of the first postoperative exhaust time [

WMD

=-16.72

95%

: (-24.76

-8.68)

0.000 1

]

the first postoperative defecation time [

WMD

=-36.10

95%

: (-50.81

-21.39)

0.000 01

]

and the first postoperative bowel sound time [

WMD

=-8.39

95%

: (-9.50，-7.27)

0.000 01

]

were statistically significant.

Conclusion

The existing clinical literature data showed that reducing the use of opioids and adopting multi⁃mode analgesia in perioperative patients can shorten the time of intestinal exhaust and defecation

and the bowel sounds appear earlier

which is more conducive to postoperative recovery.

关键词

Keywords

references

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