Abstract: ［Abstract］ Objective To systematically evaluate thepatient controlled epidural analgesia（PCEA） effect between morphine and hydromorphone， so as to provide evidence for clinical application. Methods Databases including the PubMed， Cochrane Library， WanFang Data， and CNKI （by February 2019） were searched for randomized controlled trials （RCTs） involving the PCEA effect between morphine and hydromorphone in adult patients， with no language limit. According to the modified Jadad quality scale， literature was screened， data were extracted， and quality of the included studies was critically evaluated. then meta?analysis was performed using Stata 12.0 software. Results A total of 5 RCTs involving 455 patients were included. The results of meta?analyses showed that： compared with patients in the morphine group， the incidence ofpruritus was lower for patients in the hydromorphone group； neither scores of visual analog scale（VAS） for pain at rest nor VAS scores for pain with movement differed statistically between the two groups. There was no significant difference in the incidence of nausea and vomiting and other side effects between the two groups. Conclusion Compared with morphine， PCEA with hydromorphone has less side effects and is worthy to recommend its clinical use.

Key words: meta?analysis, epidural, morphine, analgesia, hydromorphone

摘要： ［摘要］ 目的 采用meta分析系统评价吗啡与氢吗啡酮硬膜外自控镇痛的有效性与安全性。方法 检索PubMed、Cochrane Library万方和CNKI数据库，无语种限制，检索时限截至2019年2月。按照纳入及剔除标准收集评价吗啡与氢吗啡酮应用于硬膜外自控镇痛的临床研究，按照改良Jadad质量评估量表对纳入研究进行方法学质量的评估，采用Stata 12.0进行Meta分析。结果 最终共5项研究符合纳入标准，共455例患者。与吗啡组相比，氢吗啡酮组术后皮肤瘙痒的发生率明显减少；两组术后其他不良反应及镇痛评分无明显差别。结论 与吗啡相比，氢吗啡酮应用于术后硬膜外镇痛的不良反应较少。

关键词: 吗啡, Meta, 氢吗啡酮, 硬膜外, 镇痛