围手术期目标导向容量治疗用于预防腹部手术后胃肠道并发症的Meta分析  

Goal-directed fluid management prevents gastrointestinal complications in abdominal surgery ：a meta-analysis of randomized controlled trials

作　　者：郭海[1] 郑宏[1] 叶建荣[1] 汪惠才[2] 

机构地区：[1]新疆医科大学第一附属医院麻醉科,乌鲁木齐830054 [2]新疆医科大学第一附属医院循证医学教研室,乌鲁木齐830054

出　　处：《中华胃肠外科杂志》2011年第7期524-528,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：新疆维吾尔自治区科技支疆项目（200991126）

摘　　要：目的评价围术期目标导向容量治疗对预防腹部手术后胃肠道并发症的有效性，为制定临床合理的个体化容量治疗方案提供理论依据。方法计算机检索Cochrane图书馆（2010年第3期）、PubMed、EMbase、Highwire、CBM、CNKI等中外生物医学数据库。收集关于围手术期目标导向容量治疗对预防腹部手术后胃肠道并发症方面的临床随机对照试验．检索日期由2000年1月至2010年12月。按Cochrane系统评价方法．评价所纳入研究的文献质量，并提取有效数据后采用RevMan5．0软件进行Meta分析。结果纳入10项研究．共计775例患者。Meta结果显示：目标导向容量治疗可显著提高机体氧供（WMD=82．95．95％CI：17．43～148．46）．降低胃肠道术后并发症的发生率（RR=0．39．95％CI：0．29～0．52），并缩短住院天数（WMD=-2．06，95％CI：-2．95—1．17）。结论围手术期目标导向容量治疗可以有效预防术后胃肠道并发症的发生．Objective To assess whether goal-directed fluid management can prevent gastrointestinal complications in major surgery. Methods Electronic databases including Coehrane library （Issue 3,2010）, Pubmed, EMbase, Highwire, CBM, and CNKI were searched. The date of search was between January 2000 and December 2010. Randomized controlled trials （RCTs） were indentified studying association of goal-directed therapy （GDT） with gastrointestinal complications. Study selection and meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. Data were extracted from these trials by 3 reviewers independently and analyzed by RevMan5.0 software. Results Ten trials involving 775 patients were included. GDT significantly improved oxygen supply （WMD=82.95, 95% CI： 17.43-148.46）. GDT reduced postoperative hospital stay （WMD=-2.06, 95% CI：-2.95-1.17） and decreased postoperative complication rate after major surgery（RR=0.39, 95% CI： 0.29-0.52）. Conclusion Goal-directed fluid management can stabilize cardiac output, augment oxygen supply, and therefore reduce postoperative complications.

关 键 词：目标导向容量治疗:术后并发症 胃肠道 META分析 

分 类 号：R656[医药卫生—外科学]