CAJ | 학술논문

目的心搏骤停后的神经功能恢复是临床治疗的难点,实验和临床研究表明亚低温治疗是有益的.本文通过Meta分析探讨亚低温治疗对心搏骤停后患者的有效性和安全性.方法检索Medline(1966年至2012年4月)、OVID(1980年至2012年4月)、EMBASE(1980年至2012年4月)、中国生物医学文献数据库(CBM)(1978年至2012年4月)、中文生物医学期刊文献数据库(CMCC)(1995年至2012年4月)和中国医学学术会议论文数据库(CMAC)(1994年至2012年4月).纳入文献符合:①随机对照试验(RCT)；②比较常温与亚低温治疗心搏骤停心肺复苏成功的患者；③结果为神经功能恢复和出院存活.合并效应量,计算相对危险度(RR)和95％可信区间(95％ CI).结果 4个RCT共纳入417例心搏骤停心肺复苏成功的患者.与常温组比较,亚低温治疗组患者神经功能恢复更好(RR=1.43,95％ CI 1.14～ 1.80,P=0.002),出院存活更高(RR=1.32,95％ CI 1.08 ～ 1.63,P=0.008).所纳入文献报道的不良事件在两组间差异无统计学意义(P＞0.05).各研究同质性好,不存在发表偏倚.结论亚低温治疗改善了心搏骤停后患者的神经功能和出院存活.
목적 심박취정후적신경공능회복시림상치료적난점,실험화림상연구표명아저온치료시유익적.본문통과Meta분석탐토아저온치료대심박취정후환자적유효성화안전성.방법 검색Medline(1966년지2012년4월)、OVID(1980년지2012년4월)、EMBASE(1980년지2012년4월)、중국생물의학문헌수거고(CBM)(1978년지2012년4월)、중문생물의학기간문헌수거고(CMCC)(1995년지2012년4월)화중국의학학술회의논문수거고(CMAC)(1994년지2012년4월).납입문헌부합:①수궤대조시험(RCT)；②비교상온여아저온치료심박취정심폐복소성공적환자；③결과위신경공능회복화출원존활.합병효응량,계산상대위험도(RR)화95％가신구간(95％ CI).결과 4개RCT공납입417례심박취정심폐복소성공적환자.여상온조비교,아저온치료조환자신경공능회복경호(RR=1.43,95％ CI 1.14～ 1.80,P=0.002),출원존활경고(RR=1.32,95％ CI 1.08 ～ 1.63,P=0.008).소납입문헌보도적불량사건재량조간차이무통계학의의(P＞0.05).각연구동질성호,불존재발표편의.결론 아저온치료개선료심박취정후환자적신경공능화출원존활.
Objective To study the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from cardiac arrest using a meta-analysis.Methods We searched the MEDLINE (1966-April 2012),OVID (1980 to April 2012),EMBASE (1980 to April 2012),Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012),Chinese medical current contents (CMCC) (1995 to April 2012),and Chinese medical academic conference (CMAC) (1994 to April 2012).Studies were included (1) the study design was a randomized controlled trial (RCT); (2) the study population included patients successfully resuscitated from cardiac arrest,and received either conventional post-resuscitation care with normothermia or mild hypothermia; (3) the study provided data about good neurologic outcome and survival till hospital discharge.Relative risk (RR) and 95％ corfidence interval (CI) were used to pool the effect.Results The study included four RCTs with a collected total of 417 patients successfully resuscitated from cardiac arrest.Compared to conventional post-resuscitation care with normothermia,patients in the hypothermia group were more likely to have good neurologic outcome (RR =1.43,95％ CI 1.14 ～ 1.80,P =0.002) and were more likely to survive till hospital discharge (RR =1.32,95％ CI 1.08 ～ 1.63,P =0.008).From all over the studies there was no significant difference in reported adverse events between the normothermia and hypothermia group (P ＞ 0.05).There did not exist heterogeneity and publication bias.Conclusions Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from cardiac arrest.