心肺转流下心脏手术患儿围术期严格控制血糖与常规控制血糖对相关并发症影响的Meta分析  

Tight glucose control versus conventional glucose control during pediatric cardiac surgery with cardiopulmonary bypass:a meta-analysis

作　　者：曹亚楠[1] 高晓薇[1] 李曼[1] 覃罡[1] 王锷[1] 

机构地区：[1]中南大学湘雅医院麻醉科,长沙市410008

出　　处：《临床麻醉学杂志》2017年第2期157-161,共5页Journal of Clinical Anesthesiology

摘　　要：目的收集有关随机对照试验(randomized controlled trail,RCT)数据进行Meta分析,评价心肺转流(CPB)下心脏手术患儿严格控制血糖与常规控制血糖对围术期相关并发症发生率的影响,探讨CPB下心脏手术患儿围术期严格控制血糖可能的收益及风险。方法检索Pubmed、Embase、OVID、WOS、Cochrane library、CBM、CNKI、万方及维普数据库,收集关于比较CPB下心脏手术患儿围术期严格控制血糖与常规控制血糖的RCT文献,提取相关数据,采用RevMan 5.2软件进行统计学分析。结果共纳入5篇RCT文献,总计3 372例患儿。Meta分析结果显示,围术期严格控制血糖较常规控制血糖患儿术后感染发生率明显降低(RR=0.69,95%CI0.49~0.98),低血糖发生率明显增高(RR=3.34,95%CI1.33~8.34),但不会降低患儿术后院内死亡率(RR=0.78,95%CI0.47~1.30)。结论与常规控制血糖相比,心肺转流下心脏手术患儿围术期严格控制血糖能降低术后感染发生率,对术后院内死亡率无明显影响,但可能导致术后低血糖发生率增加。Objective To evaluate the benefits and risks of tight glucose control by compare the differences between tight glucose control（TGC）and conventional glucose control（CGC）during pediatric cardiac surgery with cardiopulmonary bypass（CPB）.Methods Randomized controlled trails（RCTs）in which pediatric cardiac surgery patients undergoing CPB were randomly assigned to TGC or CGC were searched through the Pubmed,Embase,OVID,WOS,Cochrane library,CBM,CNKI,Wanfang and VIP database.Data abstracted from identified articles were analyzed using Revman 5.2.Results Five RCTs involving 3 372 participants were identified.The results of meta-analysis showed that TGC was associated with the decrease in acquired infection（RR=0.69,95%CI 0.49-0.98）.While compared with CGC,TGC conversely increased the incidence of hypoglycemia（RR=3.34,95%CI1.33-8.34）and TGC did not result in a decrease in hospital mortality（RR=0.78,95%CI0.47-1.30）.Conclusion TGC during pediatric cardiac surgery with cardiopulmonary bypass appears to lower acquired infection and higher the incidence of hypoglycemia.TGC dose not reduce the incidence of hospital mortality,however.

关 键 词：患儿 血糖 心脏手术 心肺转流 META分析 

分 类 号：R726.1[医药卫生—儿科]