溶栓联合抗凝治疗次大面积肺栓塞的Meta分析

发布时间：2018-02-26 06:09

本文关键词： 次大面积肺栓塞溶栓治疗抗凝治疗 Meta分析　出处：《重庆医科大学学报》2014年06期 　论文类型：期刊论文

【摘要】：目的:系统评价溶栓联合抗凝治疗次大面积肺栓塞(submassive pulmonary embolism,SPE)的疗效和安全性。方法:计算机检索PubMed、EMbase、Cochrane Library、相关期刊论文、中国生物医学文献数据库和万方数据库,并辅手工检索其他资料,纳入溶栓联合抗凝治疗SPE的随机对照试验(randomized controlled trials,RCTs),检索日期截至2013年6月。由2名研究者按照纳入与排除标准独立筛选文献、提取资料并对纳入研究进行质量评价。用RevMan 5.0软件对数据进行Meta分析。结果:共纳入9个RCTs,共计861例患者。Meta分析结果显示:①溶栓联合抗凝疗法可提高SPE患者的总体有效率(OR=5.97,95%CI=3.51~10.15,P=0.000),与对照组比较,差异有统计学意义(P0.05);②溶栓联合抗凝疗法可有效改善患者动脉血氧分压、动脉血二氧化碳分压及肺泡-动脉血氧分压差,而且对呼吸频率及心率的改善也有一定积极作用,与对照组比较,差异有统计学意义(P0.05)。结论:现有资料表明,与单纯抗凝治疗相比,溶栓联合抗凝疗法可提高SPE患者的总体有效率,改善患者的动脉血气情况及临床相关症状。此外,溶栓联合抗凝疗法的安全性由于纳入研究质量参差不齐,故仍需后期研究进一步探讨。
[Abstract]:Objective: to evaluate the efficacy and safety of thrombolytic therapy combined with anticoagulant therapy in patients with submassive pulmonary embolism (pulmonary). Methods: a computer-based search was made for PubMedbase Cochrane Library, full text Database of Chinese Journal, Chinese Biomedical Literature Database and Wanfang Database. The random controlled trial of thrombolytic therapy combined with anticoagulant therapy was carried out in random controlled trialsl rcts, and the retrieval date was up to June 2013. The literature was independently screened by two researchers according to the criteria of inclusion and exclusion, and other data were retrieved by hand and included in the randomized controlled trial of thrombolytic and anticoagulant therapy. The data were extracted and evaluated. The data were analyzed by Meta with RevMan 5.0 software. Results: a total of 861 patients were included in the study. Meta-analysis showed that the combination of 1% thrombolytic therapy and anticoagulant therapy could improve the total number of SPE patients. The body effective rate was 5.97 ~ 95%, 3.51 ~ 10.15 ~ 0.000g / kg, compared with the control group, and compared with the control group, there was no significant difference between the control group and the control group (P < 0.05). The difference is statistically significant (P 0.05) combined with anticoagulant therapy can effectively improve the partial pressure of arterial oxygen, partial pressure of carbon dioxide in arterial blood and difference of partial pressure of oxygen between pulmonary and alveolar blood. It also has a positive effect on the improvement of respiratory rate and heart rate. Conclusion: the available data show that thrombolytic therapy combined with anticoagulant therapy can improve the overall effective rate of SPE patients compared with the control group. In addition, the safety of thrombolytic therapy combined with anticoagulant therapy is not uniform, so it needs further study.
【作者单位】：重庆医科大学附属永川医院呼吸内科;
【分类号】：R563.5

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