低温干预对成人严重颅脑损伤患者疗效的Meta分析  

Efficacy of hypothermia intervention on adult severe craniocerebral injury:a metaanalysis

作　　者：王琦 袁莉莉 丁贤慧 周志明 WANG Qi;YUAN Lili;DING Xianhui;ZHOU Zhiming(Department of Neurology,Yijishan Hospital of Wannan Medical College,Wuhu 241001,P.R.China)

机构地区：[1]皖南医学院第一附属医院,弋矶山医院神经内科,安徽芜湖241001

出　　处：《中国循证医学杂志》2020年第10期1180-1186,共7页Chinese Journal of Evidence-based Medicine

基　　金：2017皖南医学院校中青年基金(编号:KY86700312)。

摘　　要：目的系统评价低温干预对成人严重颅脑外伤的疗效。方法计算机检索CNKI、WanFang Data、VIP、CBM、PubMed、EMbase、Web of Science和The Cochrane Library数据库,搜集低温干预成人严重颅脑外伤的随机对照试验(RCT),检索时限均从建库至2020年7月2日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入25个RCT,包括2949例患者。Meta分析结果显示:低温干预组病死率低于正常体温组[RR=0.72,95%CI(0.58,0.89),P=0.003];预后良好率高于正常体温组[RR=1.29,95%CI(1.15,1.46),P<0.0001]。结论当前有限证据表明,低温干预治疗成人严重颅脑损伤病死率更少,预后更好,受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。Objectives To systematically review the efficacy of hypothermia intervention on adult severe craniocerebral injury.Methods CNKI,WanFang Data,VIP,CBM,PubMed,EMbase,Web of Science and The Cochrane Library databases were electronically searched to collect randomized controlled trials(RCTs)of hypothermia intervention on severe craniocerebral injury from the establishment of the database to July 2nd,2020.Two reviewers independently screened literature,extracted data and assessed risk of bias of included studies,then,meta-analysis was performed by using RevMan 5.3 software.Results A total of 25 RCTs involving 2949 patients were included.The results of meta-analysis showed that the mortality of hypothermia intervention group was lower than that of normal body temperature group(RR=0.72,95%CI 0.58 to 0.89,P=0.003),and the prognosis of hypothermia intervention group was better than that of normal body temperature group(RR=1.29,95%CI 1.15 to 1.46,P<0.0001).Conclusions Current evidence shows that the hypothermia intervention has a lower mortality rate and a higher prognosis rate in the treatment of adult severe brain injury.Due to limited quality and quantity of the included studies,more high quality studies are required to verify above conclusions.

关 键 词：低温 亚低温 严重颅脑损伤 META分析 系统评价 随机对照试验 

分 类 号：R651.15[医药卫生—外科学]