亚低温治疗对创伤性颅脑损伤患儿干预疗效的系统评价  

Systematic review of sub-hypothermia as an intervention measure in children with traumatic brain injury

作　　者：郭云云 刘先锋 宋丽萍[1] 杨凡[1] 范玲[1] Guo Yunyun;Liu Xianfeng;Song Liping;Yang Fan;Fan Ling(Department of Nursing,Shengjing Hospital Affiliated to China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院护理部,辽宁沈阳110004 [2]中国医科大学护理学院

出　　处：《护理学杂志》2020年第14期96-99,103,共5页Journal of Nursing Science

摘　　要：目的系统评价亚低温治疗对创伤性颅脑损伤患儿疗效的影响。方法计算机检索中国期刊全文数据库(CNKI)、中国生物医学文献服务系统(SinoMed)、万方数据库、PubMed、Web of Science等,查找有关随机对照试验研究,用Rev Man5.3、Stata15.0软件进行Meta分析。结果纳入14篇文献,共924例颅脑损伤患儿。Meta分析显示,亚低温组与常温组病死率、格拉斯哥结局评分差异无统计学意义(均P>0.05)。在早期对降低患儿颅内压有一定作用。亚低温组与常温组比较,显著增加心律失常发生率(P<0.05),而其他并发症(如感染、出血、凝血功能障碍、肺炎、ARDS、败血性休克)发生率比较,差异无统计学意义(均P>0.05)。结论亚低温干预对颅脑损伤有一定疗效,但应用于颅脑损伤患儿的体温管理尚需综合谨慎考虑。Objective To systematically evaluate the effect of sub-hypothermia intervention on children with severe brain injury.Methods Computer-based search was conducted in such databases or websites as Chinese National Knowledge Infrastructure(CNKI),SinoMed,Wanfang Data,PubMed,Web of Science,etc.,to find relevant RCTs.Rev Man 5.3 and Stata 15.0 were used for Meta-analysis.Results A total of 924 children were included in 14 RCTs.Meta-analysis showed that there were no significant differences in mortality and Glasgow Outcome Scale(GOS)scores between sub-hypothermia and normal temperature groups(P>0.05 for all).Sub-hypothermia played some role in early reduction of intracranial pressure(ICP)in children.Compared with normal temperature group,sub-hypothermia group significantly increased the incidence rate of arrhythmia(P<0.05).The differences in the incidence rates of other complications(as in infection,bleeding,coagulation dysfunction,pneumonia,ARDS,and septic shock)between sub-hypothermia and normal temperature group were not significant(P>0.05 for all).Conclusion Although hypothermia has some effect on brain injury,its application in temperature management in children with brain injury should be cautiously considered.

关 键 词：儿童 颅脑损伤 亚低温治疗 死亡 系统评价 

分 类 号：R473.72[医药卫生—护理学]