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目的:采用Meta分析评价氨茶碱对硬脊膜穿破后头痛(PDPH)的预防作用。方法:计算机检索PubMed、Cochrane图书馆、EMBASE、中国期刊全文数据库、中国科技期刊全文数据库(CNKI)、数字化期刊全文数据库(万方),手工检索会议论文,检索时间范围为数据库建立时间至2020年11月30日。纳入椎管内麻醉下行手术治疗的患者静脉输注氨茶碱的临床随机对照研究。采用Cochrane系统评价纳入文献质量,RevMan 5.3统计软件进行统计分析。文献根据手术结束前是否静脉给予氨茶碱分为氨茶碱组和对照组。术后第1、2、7日时患者硬脊膜穿破后头痛的发生率为主要观察指标;静脉注射氨茶碱后患者不良反应发生率为次要观察指标。结果:共纳入5篇文章434例患者,其中给予氨茶碱静脉输注者217例,对照组(未静脉给予氨茶碱)217例。与对照组相比,氨茶碱组患者PDPH发生率在术后第1日[n OR=0.14,95%n CI(0.04~0.41),n P=0.0004]、第2日[n OR=0.24,95%n CI(0.11~0.52),n P=0.0003]、第7日[n OR=0.41,95%n CI(0.22~0.77),n P=0.006]明显降低,而两组不良反应差异无统计学意义[n OR=5.35,95%n CI(0.25~116.31),n P=0.29]。n 结论:氨茶碱对硬脊膜穿破后头痛有预防作用,且不增加不良反应发生率。“,”Objective:To systematically review the efficacy of intravenous aminophylline for preventing post-dural puncture headache (PDPH) in patients after epidural anesthesia.Methods:Databases including PubMed, Cochrane Library, Embase, China National Knowledge Internet (CNKI), Wanfang Medical Database, VIP Database for Chinese Technical Periodicals were searched by computers and conference papers were manually searched, time range from database establishment to November 30, 2020. The randomized, controlled clinical trials of intravenous aminophylline were included in patients with epidural anesthesia. The quality of included literatures was evaluated by Cochrane systemtic evaluation. RevMan 5.3 statistical software was used for statistical analysis. The patients were injected aminophylline intravenously in aminophylline group, and not injected in the control group. The primary outcome was the incidence of PDPH in patients at the first day, the second day and the seventh day after the surgery. The secondary outcome was the incidence of adverse reactions.Results:Five studies involving 434 patients were included in this Meta analysis. Among the 434 patients, aminophylline was administered by intravenous injection in 217 cases, the other 217 patients without using aminophylline. There was statistically significant difference in the incidence of PDPH at the first day[n OR=0.14, 95%n CI(0.04-0.41), n P=0.0004], the second day[n OR=0.24, 95%n CI(0.11-0.52), n P=0.0003] and the seventh day[n OR=0.41, 95%n CI(0.22-0.77), n P=0.006] after epidural anesthesia in the two groups (n P<0.01), but no significant difference of adverse reactions was observed between the two groups [n OR=5.35, 95%n CI(0.25-116.31), n P=0.29].n Conclusion:Intravenous aminophylline can prevent post-dural puncture headache after epidural anesthesia.