心肺转流下心脏手术患儿围术期严格控制血糖与常规控制血糖对相关并发症影响的Meta分析

发布时间：2018-04-17 05:33

本文选题：患儿 + 血糖　；参考：《临床麻醉学杂志》2017年02期

【摘要】：目的收集有关随机对照试验(randomized controlled trail,RCT)数据进行Meta分析,评价心肺转流(CPB)下心脏手术患儿严格控制血糖与常规控制血糖对围术期相关并发症发生率的影响,探讨CPB下心脏手术患儿围术期严格控制血糖可能的收益及风险。方法检索Pubmed、Embase、OVID、WOS、Cochrane library、CBM、CNKI、万方及维普数据库,收集关于比较CPB下心脏手术患儿围术期严格控制血糖与常规控制血糖的RCT文献,提取相关数据,采用RevMan 5.2软件进行统计学分析。结果共纳入5篇RCT文献,总计3 372例患儿。Meta分析结果显示,围术期严格控制血糖较常规控制血糖患儿术后感染发生率明显降低(RR=0.69,95%CI0.49~0.98),低血糖发生率明显增高(RR=3.34,95%CI1.33~8.34),但不会降低患儿术后院内死亡率(RR=0.78,95%CI0.47~1.30)。结论与常规控制血糖相比,心肺转流下心脏手术患儿围术期严格控制血糖能降低术后感染发生率,对术后院内死亡率无明显影响,但可能导致术后低血糖发生率增加。
[Abstract]:Objective to collect random controlled trailage data from randomized controlled trials for Meta analysis, and to evaluate the effect of strict blood glucose control and routine blood glucose control on the incidence of perioperative complications in children undergoing cardiopulmonary bypass (CPB).To explore the possible benefits and risks of strict blood glucose control in children undergoing cardiac surgery under CPB.Methods We searched the database of Pubmedus Embase OVIDB WOS Cochrane libraryCBI, Wanfang and Weip, collected and analyzed the data of RCT about strict blood glucose control and routine blood glucose control in children undergoing cardiac surgery under CPB. The data were analyzed by RevMan 5.2 software.Results A total of 5 articles of RCT were included.The incidence of infection during perioperative period was significantly lower than that in children with routine blood glucose control. The incidence of hypoglycemia was significantly higher than that of routine blood glucose control. The incidence of hypoglycemia was 3.3495 CI 1.338.34, but it did not decrease the mortality rate of RRN 0.7895 CI 0.471.30%.Conclusion compared with conventional blood glucose control, perioperative control of blood glucose in children undergoing cardiopulmonary bypass surgery can reduce the incidence of postoperative infection, and have no significant effect on postoperative hospital mortality, but may lead to an increase in the incidence of hypoglycemia after cardiopulmonary bypass.
【作者单位】：中南大学湘雅医院麻醉科;
【分类号】：R726.1

【参考文献】