CAJ | 학술논문

目的以Meta分析方法研究75 g/L氯化钠(NaCl)溶液对创伤后失血性休克液体复苏的临床疗效. 方法检索PUBMED、EMBASE、OVID、Cochrane图书馆、EBSCO数据库,根据制定的入选标准筛选随机对照试验(randomized controlled trial,RCT),并进行文献质量评价.对选定的RCT提取和分析患者的血压、血红蛋白、血钠和病死率等指标,以等渗晶体液为参照评价75 g/L氯化钠溶液的有效性和安全性.采用Review Manager 5.0.25分析提取的相关数据. 结果共有6篇RCT符合入选标准.分析表明75 g/L氯化钠溶液相对于等渗晶体液可以早期、快速提升血压(标准差=6.23,95％CI 2.78～9.69,P＜0.01),同时可以造成血红蛋白含量的下降(标准差=-6.11,95％CI -8.25～ -3.96,P＜0.01)；75 g/L氯化钠溶液产生的短期高渗状态总体上是有效和安全的(标准差=7.97,95％ CI 7.55～ 8.38,P＜0.01)；75 g/L氯化钠溶液组与等渗晶体液组比较,创伤失血性休克患者的住院病死率差异无统计学意义(风险率=0.96,95％ CI0.84 ～1.10,P＞0.05). 结论创伤后失血性休克液体复苏中使用小容量75 g/L氯化钠溶液是安全和有效的.
목적 이Meta분석방법연구75 g/L록화납(NaCl)용액대창상후실혈성휴극액체복소적림상료효. 방법 검색PUBMED、EMBASE、OVID、Cochrane도서관、EBSCO수거고,근거제정적입선표준사선수궤대조시험(randomized controlled trial,RCT),병진행문헌질량평개.대선정적RCT제취화분석환자적혈압、혈홍단백、혈납화병사솔등지표,이등삼정체액위삼조평개75 g/L록화납용액적유효성화안전성.채용Review Manager 5.0.25분석제취적상관수거. 결과 공유6편RCT부합입선표준.분석표명75 g/L록화납용액상대우등삼정체액가이조기、쾌속제승혈압(표준차=6.23,95％CI 2.78～9.69,P＜0.01),동시가이조성혈홍단백함량적하강(표준차=-6.11,95％CI -8.25～ -3.96,P＜0.01)；75 g/L록화납용액산생적단기고삼상태총체상시유효화안전적(표준차=7.97,95％ CI 7.55～ 8.38,P＜0.01)；75 g/L록화납용액조여등삼정체액조비교,창상실혈성휴극환자적주원병사솔차이무통계학의의(풍험솔=0.96,95％ CI0.84 ～1.10,P＞0.05). 결론 창상후실혈성휴극액체복소중사용소용량75 g/L록화납용액시안전화유효적.
Objective To investigate the efficacy and safety of fluid resuscitation with 75 g/L NaCl solution in traumatic hypovolemic shock using Meta-analysis. Methods Based on the inclusion criteria,the randomized controlled trials (RCTs) were identified by retrieving the databases including PUBMED,EMBASE,OVID,Cochrane library and EBSCO.The quality of studies was also evaluated.Indices including systolic blood pressure,hemoglobin,serum Na level and mortality were extracted from the enrolled RTCs and were comparatively analyzed between the 75 g/L NaCl group and the isotonic saline group for evaluating the safety and efficacy of 75 g/L NaCI solution.The extracted data were analyzed by using the Review Manager 5.0.25. Results Six RCTs were eligible for Meta-analysis.The 75 g/L NaCl group displayed remarkable increase in systolic blood pressure and decrease in hemoglobin level,compared with the isotonic saline group ( MD =6.23,95％ CI 2.78-9.69,P ＜ 0.01 ; MD =-6.11,95％CI -8.25-3.96,P ＜ 0.01,respectively).Short-term hyperosmolar state in 75 g/L NaCl group was increased significantly but was considered acceptable ( MD =7.97,95％ CI 7.55-8.38,P ＜ 0.01 ).No significant difference in mortality was found between 75 g/L NaCl group and isotonic saline group ( RR =0.96,95％ CI 0.84-1.10,P ＞ 0.05). Conclusion Fluid resuscitation with 75 g/L NaCl solution is safe and effective for traumatic hypovolemic shock.