局部亚低温对脑出血患者脑水肿和神经功能恢复影响的Meta分析  

Effects of local mild hypothermia on cerebral edema volume and the rehabilitation of neurological function in patients with cerebral hemorrhage: A Meta analysis

作　　者：蒋亚斌[1] 赵素华[2] 叶开和[3] 

机构地区：[1]暨南大学附属第一医院急诊科,广东省广州市510632 [2]广州市脑科医院精神科,广东省广州市510370 [3]暨南大学药学院药理学教研室,广东省广州市510632

出　　处：《中国临床康复》2005年第33期6-7,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:应用Meta分析方法了解局部亚低温对脑出血患者脑水肿体积和神经功能恢复的影响,以进一步认识局部亚低温治疗脑出血的临床疗效。方法:实验于2004/12在暨南大学附属第一医院急诊科进行,计算机检索CNKI1994/2004与脑出血患者局部亚低温治疗相关文章,文章须有对照组,并以“欧洲卒中量表”为评估标准进行评估。应用Meta分析对检索出的符合要求的8项研究局部亚低温治疗脑出血的对照研究进行再分析,评价其综合显著性差异和效应大小。结果:纳入8篇文章进入Meta分析。①治疗组与对照组在治疗前的脑水肿体积比较:综合检验Z=0.16,自由度10,P>0.25。②治疗组与对照组在治疗后的脑水肿体积的比较:综合检验Z=4.39,自由度10,P<0.001;ES:d平均=1.24。③治疗组亚低温治疗前后的欧洲卒中评分的比较:综合检验Z=28.05,自由度16,P<0.001;ES:d平均=2.44。④治疗组与对照组治疗前后欧洲卒中评分的组间比较:综合检验Z=5.39,自由度16,P<0.001;ES:d平均=1.36。结论:局部亚低温可显著降低脑出血患者的脑水肿体积,同时对患者的神经功能缺损有显著的改善作用。AIM： To investigate the effects of local mild hypothermia on cerebral edema volume and the rehabilitation of neurological function in patients with cerebral hemorrhage by using Meta analysis, so as to further recognize the clinical efficacy of local mild hypothermia in treatment of cerebral hemorrhage. METHODS： Experiment was conducted in the Department of Emergency, the First Affiliated Hospital of Jinan University in December 2004. Articles related to local mild hypothermia for cerebral hemorrhage were retrieved using computer in China National Knowledge Infrastructure from 1994 to 2004, in which, there were control groups, and Europe Stroke Scale was used as assessment standard. Eight articles related to the controlled studies on the local mild hypethermia for treatment of cerebral hemorrhage,which accorded with demand, were analyzed by meta-analysis again in order to assess the comprehensively significant differences and the effect size（ES） of local mild hypothermia. RESULTS： Totally eight articles were involved in the Meta analysis. ① Comparison of cerebral edema volume between treatment group and control group before treatment： Z=0.16,free degree 10, P〉 0.25. ②Comparison of cerebral edema volume between treatment group and control group after treatment： Z=4.39, free degree 10, P 〈 0.001; ES： dmean=1.24. ③Comparison of scores on European Stroke Scale in treatment group before and after treatment： Z=28.05,, free degree 16, P 〈 0.1301 ; ES：dmean=2.44. @Comparison of scores on European Stroke Scale between treatment group and control group before and after treatment： Z=5.39,free degree 16,P〈0.001;ES：mean=1.36. CONCLUSION： Local mild hypothermia can not only reduce cerebral edema volume signifieandy but also improve neurological function of patients with cerebral hemorrhage dramatically.

关 键 词：脑出血 低温 人工 脑水肿 康复 综合分析 

分 类 号：R743.34[医药卫生—神经病学与精神病学]