生理盐水代替乙醇皮试消毒液效果的系统评价

摘要

Objective:To evaluate the effect of normal saline instead of ethanol disinfectant in the skin test.Methods:Randomized controlled trials (RCTs) on using normal saline as skin disinfectant instead of ethanol in skin test were searched among Cochrane Library,Chinese Journal of Biotechnology,VIPs,Wan Fang,PubMed Data Resource System.The quality evaluation of RCTs was carried out and valid data was extracted.RevMan 5.3 software was used for meta-analysis.Results:A total of 11 RCTs were included.Results of 10 RCTs showed that normal saline as skin disinfectant could reduce the positive rate of skin test results[OR=0.43,95%CI(0.23,0.81),P=0.009].3 studies showed that the false positive rate of normal saline group was lower than that in ethanol group [OR=0.12,95%CI(0.02,0.79),P=0.03].3 studies showed that sensitivity after skin test had no differences between the normal saline group and ethanol group [OR=0.80,95%CI(0.37,1.70),P=0.56].Conclusion:Normal saline instead of ethanol as skin disinfectant could effectively reduce the positive rate and false positive rate of skin test,and there was no statistically significant difference in allergic rate after treatment.However,since the quality of the included studies was not good,the effect of normal saline instead of ethanol as skin disinfectant still required a large sample of high quality randomized controlled trials to further verify.%[目的]评价皮试时用生理盐水代替乙醇消毒液的效果.[方法]计算机检索Cochrane Library、中国知网、维普、 万方、PubMed数据资源系统中关于皮试病人应用生理盐水和乙醇作为皮试消毒液的随机对照试验(RCTs),对纳入的RCTs进行质量评价,并提取有效数据,采用RevMan 5.3软件进行Meta分析.[结果]共纳入11个RCT.10项RCT结果显示生理盐水作为皮试擦拭液可降低皮试结果阳性率[OR=0.43,95%CI (0.23,0.81),P=0.009],3项研究表明生理盐水组较乙醇组皮试假阳性率较低[OR=0.12,95%CI(0.02,0.79),P=0.03];3项研究结果表明生理盐水与乙醇作为皮试擦拭液,皮试后过敏率无差异[OR=0.80,95%CI(0.37,1.70),P=0.56].[结论]用生理盐水代替乙醇作为皮试擦拭液可有效降低病人皮试阳性率和假阳性率,且用药后过敏率无统计学差异,但因纳入的研究质量不高,生理盐水代替乙醇作为皮试擦拭液的效果仍需要大样本高质量的随机对照试验进一步验证.