碳酸氢钠对合并代谢性酸中毒的重症病人结局影响的Meta分析  

Effects of sodium bicarbonate on the outcomes of critical ill patients with Metabolic acidosis:a Meta-analysis

作　　者：侯佳彤 保晶[2] 梁杰佳 段军[1] HOU Jiatong;BAO Jing;LIANG Jiejia;DUAN Jun(China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院外科重症医学科,北京100029 [2]中日友好医院肝移植科,北京100029

出　　处：《中国急救复苏与灾害医学杂志》2023年第3期332-335,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家自然科学基金(编号:81774265)。

摘　　要：目的对目前的文献进行了回顾和Meta分析,总结了使用碳酸氢钠对危重症患者预后影响的证据。方法检索了EMBASE、Medline、Cochrane图书馆收录的2022年3月前的相关文献。所有相关文献的参考书目都是手动对文献进行全文检索。引文表是由两位作者分别检索的。共纳入7项研究。结果共纳入7项研究,总样本数1136人。与对照组相比,碳酸氢钠治疗对重症病人的死亡率(OR=0.94;95%CI:0.72~1.23;P=0.67)、机械通气时间长短(RR=0.18;95%CI:0.82~1.18;P=0.72)及ICU住院时间(RR=0.51;95%CI:2.05~1.02;P=0.51)差异无统计学意义。碳酸氢钠治疗组需要进行肾脏替代治疗(renal replacement treatment,RRT)的比例相较于对照组降低(OR=0.66;95%CI:0.47~0.93;P=0.02)。结论碳酸氢钠用于治疗重症病人代谢性酸中毒对死亡率、机械通气时间、ICU住院时间无明显影响,但可降低住院期间需RRT的患者比例。Objective To a review and Meta-analysis of the current literatures to summarize the evidences on the effects of sodium bicarbonate on outcomes in critically ill patients.Methods EMBASE,Medline,Cochrane Library were searched till Mar.2022.The bibliography of all relevant articles was hand searched.Full-text searching of the literature was done through the medical institution database.The citation list was searched by two authors.A total of 7 studies were included.Results A sum of 7 studies were included with a sample size of 1136 patients.Compared with the control group,the mortality rate of critical ill patients treated with sodium bicarbonate(OR=0.94;95%CI:0.72~1.23;P=0.67),the time of mechanical ventilation(RR=0.18;95%CI:0.82~1.18;P=0.72)and the length of ICU stay(RR=0.51;95%CI:2.05~1.02;P=0.51)had no statistical difference.The proportion of patients requiring renal replacement treatment(RRT)was lower than that of the control group(OR=0.66;95%CI:0.47~0.93;P=0.02).Conclusion Sodium bicarbonate used as the treatment of Metabolic acidosis in critical ill patients has no significant effects on mortality,mechanical ventilation duration and the length of ICU stay,but can reduce the proportion of patients requiring RRT during hospitalization.

关 键 词：碳酸氢钠 代谢性酸中毒 META分析 

分 类 号：R69[医药卫生—泌尿科学]