不同剂量甘露醇降低颅内压效果的系统评价

发布时间：2019-02-15 12:30

【摘要】：目的系统评价应用不同剂量甘露醇治疗颅内压增高的效果,为临床使用甘露醇的用量提供依据。方法计算机检索The Cochrane Library、PubMed、Ovid、Web of Science、EMbase、Google学术搜索引擎、知网、万方、维普、中文生物医学期刊数据库,纳入使用125mL(或0.25~0.5g/kg-1)和250mL(或0.5~1g/kg-1)两种剂量的20%甘露醇降低颅内压的随机对照试验(RCT),检索时限均为建库至2014-06。由2名评价者按照纳入与排除标准独立进行文献筛选、资料提取和方法学质量评价,采用RevMan 5.2软件进行Meta分析。结果最终纳入6个RCT,共1 582例患者。经Meta分析,5篇文章中125mL与250mL的20%甘露醇降低颅内压效果差异无统计学意义(P0.05),6篇文章显示,125mL的20%甘露醇不良反应较250%mL的20%甘露醇少。2篇文章治疗结束时2组的病死率相同。结论 125mL与250mL的20%甘露醇降低颅内压效果相当,而125mL甘露醇的不良反应250mL甘露醇,推荐临床使用125mL甘露醇降低颅内压。
[Abstract]:Objective to evaluate the effect of different doses of mannitol in the treatment of intracranial hypertension and to provide evidence for clinical use of mannitol. Methods The Cochrane Library,PubMed,Ovid,Web of Science,EMbase,Google academic search engine, Zhiwang, Wanfang, Weipu, Chinese biomedical journal database were searched by computer. In the randomized controlled trial of 20% mannitol with 125mL (or 0.25~0.5g/kg-1) and 250mL (or 0.5~1g/kg-1) to reduce intracranial pressure, the (RCT), retrieval time was built to 2014-06. According to the criteria of inclusion and exclusion, two evaluators carried out independent literature screening, data extraction and methodological quality evaluation. Meta analysis was carried out with RevMan 5.2 software. Results 1 582 patients with 6 RCT, were included. By Meta analysis, there was no significant difference in the effect of 20% mannitol between 125mL and 250mL on the reduction of intracranial pressure in 5 articles (P0.05). The adverse reaction of 20% mannitol in 125mL was less than that in 250%mL. The mortality of the two groups was the same at the end of treatment. Conclusion the effect of 20% mannitol in 125mL and 250mL in reducing intracranial pressure is equal, but the adverse reaction of 125mL mannitol is 250mL mannitol. It is recommended that 125mL mannitol be used clinically to reduce intracranial pressure.
【作者单位】：郑州大学第二附属医院;
【分类号】：R96

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