血栓弹力图指导心脏外科手术围术期临床治疗meta分析  

Thrombelastogram in Guidance of Clinical Treatment during Perioperative Period of Cardiac Surgical Procedures:a Meta Analysis

作　　者：胡贵锋[1] 张斌[1] 李俊杰[1] 尹文[1] HU Gui-feng ZHANG Bin LI Jun-jie YIN Wen(Emergency Department, Xijing Hospital of the Fourth Military Medical U- niversity, Xi＇an 710032, China)

机构地区：[1]第四军医大学西京医院急诊科,西安710032

出　　处：《临床误诊误治》2017年第9期65-69,共5页Clinical Misdiagnosis & Mistherapy

基　　金：陕西省自然科学基础研究计划项目(2014JM4186);西京医院学科助推计划(XJZT14D10)

摘　　要：目的探讨血栓弹力图(TEG)指导心脏外科手术围术期临床治疗的有效性及安全性。方法计算机检索中国生物医学文献数据库(1990~2016年)、中国学术期刊全文数据库(1990~2016年)、PubMed(1975~2016年)、The Cochrane Library(1980~2016年)及Embase数据库(1975~2016年)收录的所有心脏外科手术围术期TEG指导临床治疗的随机对照试验(RCT)相关文献,依据改良Jadad量表评价文献,提取相关资料并使用Review Manager5.3统计学软件进行数据分析。结果本研究纳入10篇RCT文献,其中6篇为高质量文献,4篇为低质量文献。meta分析结果显示,与对照组比较,TEG组围术期红细胞输注率[RR=0.83,95%可信区间(0.75,0.92),P=0.0004]、新鲜冰冻血浆输注率[RR=0.41,95%可信区间(0.32,0.52),P<0.00001]、术后再次手术率[RR=0.56,95%可信区间(0.33,0.97),P=0.04]差异均有统计学意义。结论 TEG能有效指导心脏外科手术围术期的临床治疗,安全性好。Objective To discuss effectiveness and safety of thrombelastogram（ TEG） in guidance of clinical treatment during perioperative period of cardiac surgical procedures. Methods Randomized controlled trails（ RCT） pertinent papers about TEG in guidance of clinical treatment during perioperative period of cardiac surgical procedures were searched on CBM（ 1990-2016）,CNKI（ 1990-2016）,PubMed（ 1975-2016）,The Cochrane Library（ 1980-2016） and Embase（ 1975-2016） databases by computer. The papers were evaluated by improved Jadad scale,and corresponding papers were selected and performed data analysis by Review Manager 5. 3 statistics software. Results A total of 10 papers were included in this study,and there were 6 high-quality papers and 4 poor-quality papers. Meta analysis showed that there were significant differences in erythrocyte transfusion rate [RR = 0. 83,95% CI（ 0. 75,0. 92）,P = 0. 0004],fresh frozen plasma of transfusion rate [RR = 0. 41,95% CI（ 0. 32,0. 52）,P〈 0. 00001] and postoperative reoperation rate [RR = 0. 56,95% CI（ 0. 33,0. 97）,P = 0. 04]during perioperative period in TEG group compared with those in control group. Conclusion TEG can effectively guide clinical treatment during perioperative period of cardiac surgical procedures with good safety.

关 键 词：血栓弹力图 心脏外科手术 围手术期 META分析 

分 类 号：R654.2[医药卫生—外科学]