中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
Chinese Journal of Emergency Medicine
2015年
9期
1017-1022
,共6页
钱会银%朱建良%邹勤华%周保纯%赵旭明%陆件%刘励军
錢會銀%硃建良%鄒勤華%週保純%趙旭明%陸件%劉勵軍
전회은%주건량%추근화%주보순%조욱명%륙건%류려군
治疗性低温%心脏骤停%神经功能预后%存活率%Meta分析
治療性低溫%心髒驟停%神經功能預後%存活率%Meta分析
치료성저온%심장취정%신경공능예후%존활솔%Meta분석
Therapeutic hypothermia%Cardiac arrest%Neurological status%Survival%Meta-analysis
目的 系统评价治疗性低温对心脏骤停患者神经功能预后和存活率的影响.方法 检索MEDLINE、PubMed、荷兰医学文摘(EMBASE)、Cochrane图书馆、万方数据库、中国期刊网全文数据库(CNKI)和中国生物医学文献数据库(CBM),纳入治疗性低温对心脏骤停患者的随机对照实验(RCT),结局指标为神经功能预后和存活率.采用RevMan 5.0软件进行Meta分析,二分类变量效应量用相对危险度(RR)及其95％可信区间(CI)表达,以P＜0.05为差异具有统计学意义.结果 在8个随机对照实验中,共1 512例心脏骤停患者.与常温组比较,治疗性低温能改善患者神经功能预后,且差异具有统计学意义(RR=1.34,95％ CI:1.01～1.78,P＜0.05);两组存活率比较差异无统计学意义(RR =1.09,95％CI:0.98～1.20,P＞0.05).与常温组比较,应用传统降温方法的治疗性低温能改善患者神经功能预后,且差异具有统计学意义(RR=1.51,95％ CI:1.22～1.87,P＜0.01);传统降温方法的治疗性低温能提高存活率,差异具有统计学意义(RR=1.36,95％CI:1.13 ～1.63,P＜0.01).结论 治疗性低温能改善心脏骤停后患者神经功能预后,不能提高存活率;应用传统降温方法的治疗性低温不但能改善患者神经功能预后,而且能提高存活率.
目的 繫統評價治療性低溫對心髒驟停患者神經功能預後和存活率的影響.方法 檢索MEDLINE、PubMed、荷蘭醫學文摘(EMBASE)、Cochrane圖書館、萬方數據庫、中國期刊網全文數據庫(CNKI)和中國生物醫學文獻數據庫(CBM),納入治療性低溫對心髒驟停患者的隨機對照實驗(RCT),結跼指標為神經功能預後和存活率.採用RevMan 5.0軟件進行Meta分析,二分類變量效應量用相對危險度(RR)及其95％可信區間(CI)錶達,以P＜0.05為差異具有統計學意義.結果 在8箇隨機對照實驗中,共1 512例心髒驟停患者.與常溫組比較,治療性低溫能改善患者神經功能預後,且差異具有統計學意義(RR=1.34,95％ CI:1.01～1.78,P＜0.05);兩組存活率比較差異無統計學意義(RR =1.09,95％CI:0.98～1.20,P＞0.05).與常溫組比較,應用傳統降溫方法的治療性低溫能改善患者神經功能預後,且差異具有統計學意義(RR=1.51,95％ CI:1.22～1.87,P＜0.01);傳統降溫方法的治療性低溫能提高存活率,差異具有統計學意義(RR=1.36,95％CI:1.13 ～1.63,P＜0.01).結論 治療性低溫能改善心髒驟停後患者神經功能預後,不能提高存活率;應用傳統降溫方法的治療性低溫不但能改善患者神經功能預後,而且能提高存活率.
목적 계통평개치료성저온대심장취정환자신경공능예후화존활솔적영향.방법 검색MEDLINE、PubMed、하란의학문적(EMBASE)、Cochrane도서관、만방수거고、중국기간망전문수거고(CNKI)화중국생물의학문헌수거고(CBM),납입치료성저온대심장취정환자적수궤대조실험(RCT),결국지표위신경공능예후화존활솔.채용RevMan 5.0연건진행Meta분석,이분류변량효응량용상대위험도(RR)급기95％가신구간(CI)표체,이P＜0.05위차이구유통계학의의.결과 재8개수궤대조실험중,공1 512례심장취정환자.여상온조비교,치료성저온능개선환자신경공능예후,차차이구유통계학의의(RR=1.34,95％ CI:1.01～1.78,P＜0.05);량조존활솔비교차이무통계학의의(RR =1.09,95％CI:0.98～1.20,P＞0.05).여상온조비교,응용전통강온방법적치료성저온능개선환자신경공능예후,차차이구유통계학의의(RR=1.51,95％ CI:1.22～1.87,P＜0.01);전통강온방법적치료성저온능제고존활솔,차이구유통계학의의(RR=1.36,95％CI:1.13 ～1.63,P＜0.01).결론 치료성저온능개선심장취정후환자신경공능예후,불능제고존활솔;응용전통강온방법적치료성저온불단능개선환자신경공능예후,이차능제고존활솔.
Objective To evaluate the effects of therapeutic hypothermia on both neurological status and survival rate in patients after cardiac arrest.Methods The data were searched from MEDLINE,PubMed,EMBASE,Cochrane Library,Wanfang database,CNKI and CBM.The randomized and controlled trials were selected for evaluating the main outcomes of neurological status and survival rate in patients after cardiac arrest.Meta-analysis was carried out by using Review Manger 5.0 software.The results were expressed in risk ratio (RR) for dichotomous outcomes data with 95％ confidence intervals (CI),and P ＜ 0.05 was considered to be significant.Results Eight randomized controlled clinical trials with a total of 1 512 patients met our inclusion criteria.The overall risk ratio of favorable neurological status was 1.34 (95％ CI:1.01-1.78,P ＜0.05) and of survival rate was 1.09 (95％ CI:0.98-1.20,P ＞0.05) with therapeutic hypothermia compared with controls,however,when the applications of conventional cooling trials were analyzed,the risk ratio was 1.51 (95％ CI:1.22-1.87,P ＜0.01) and 1.36 (95％CI:1.13 -1.63,P ＜ 0.01),respectively.Conclusions Patients treated with therapeutic hypothermia after cardiac arrest had more favorable neurological status compared with the controls.There was no benefit of therapeutic hypothermia to survival rate identified.Compare with conventional cooling methods,the therapeutic hypothermia could improve neurological status and survival rate in patients after cardiac arrest.
