强化胰岛素治疗对ICU获得性衰弱的干预效果Meta分析

发布时间：2018-01-11 09:23

本文关键词：强化胰岛素治疗对ICU获得性衰弱的干预效果Meta分析　出处：《重庆医学》2016年11期 　论文类型：期刊论文

【摘要】：目的系统评价强化胰岛素治疗对ICU患者ICU获得性衰弱(ICUAW)的干预效果,为制订ICU获得性衰弱干预策略提供参考依据。方法计算机及手工检索CBM、CNKI、万方、维普、PubMed、Cochrane Library、EMBASE、ISI数据库中相关文献,由两名研究者按严格的标准进行文献筛选、质量评价及数据提取,采用RevMan5.3软件对提取数据进行Meta分析。结果纳入分析文献3篇,ICU患者2 788例,其中试验组1 380例,对照组1 408例,Meta分析结果显示与常规胰岛素治疗相比,强化胰岛素治疗可降低ICUAW的发病率(RR=0.61,95%CI:0.42~0.89,P=0.01),但其对患者ICU病死率(RR=0.74,95%CI:0.47~1.17,P=0.20)、患者院内病死率(RR=0.81,95%CI:0.58~1.13,P=0.22)、ICU监护时间(MD=0,95%CI:-0.37~0.37,P=1.00)、机械通气时间(MD=-1.48,95%CI:-3.43~0.47,P=0.14)的影响不明显。结论基于现有证据得出强化胰岛素治疗可减少ICU患者ICUAW的发病率,但其对患者ICU病死率、院内病死率、ICU监护时间及机械通气时间的影响还需进一步研究验证。
[Abstract]:Objective to evaluate the effect of intensive insulin therapy on ICU acquired weakness in ICU patients. Methods ICU CNKI, Wanfang and Weipu PubMed were searched by computer and hand. The Cochrane Library EMBASEI database was used for literature screening, quality evaluation and data extraction by two researchers according to strict criteria. RevMan5.3 software was used to analyze the extracted data by Meta. Results 2 788 patients were included in 3 articles, including 1 380 cases in the experimental group. The results of Meta-analysis of 1 408 cases in the control group showed that intensive insulin therapy could reduce the incidence of ICUAW by 0.61 compared with routine insulin therapy. 95 CI: 0.42 / 0.89P0. 01%, but its mortality rate for ICU is 0.74% CI: 0.471.17% P0. 20). The mortality rate in the hospital was 0.81 / 95 CI: 0.58 / 1.13 / 0.22 and ICU monitoring time: MD0and 95% CI: -0.37 / 0.37. P = 1.00, mechanical ventilation time = MD-1.48 / 95 / CI: -3.43 / 0.47. Conclusion based on the available evidence, intensive insulin therapy can reduce the incidence of ICUAW in patients with ICU, but it can reduce the mortality of ICU and hospital mortality. The effects of ICU monitoring time and mechanical ventilation time need to be further studied and verified.
【作者单位】：遵义医学院研究生院;遵义医学院附属医院ICU;遵义医学院附属医院护理部;
【基金】：贵州省2013~2014年度国家临床重点专科建设项目(国卫办医函[2013]544号) 贵州省卫生计生委科学技术基金(gzwjkj2014-1-077)
【分类号】：R459.7
【正文快照】： ICU获得性衰弱(Intensive care unit acquired weakness,ICUAW)是ICU患者常见的一种获得性神经肌肉功能障碍疾病,也称ICU获得性肌无力、ICU获得性神经肌肉疾病、危重病性多发性神经肌病等,其在ICU患者中发病率为25%~85%[1],脓毒症患者使用皮质类固醇治疗时其发病率可高达100%[

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