不同液体管理对急性肺损伤患者预后影响Meta分析

发布时间：2018-03-27 05:19

本文选题：急性肺损伤　切入点：液体管理　出处：《新疆医科大学》2013年硕士论文

【摘要】：目的：系统评价不同液体管理方案对急性肺损伤患者预后的影响，为临床应用提供依据。方法：通过计算机检索CNKI、CBM、万方、维普、Pubmed、CENTRAL、Springer、Elsevier、Critical Care Medicine、Intensive Care Medicine、The AmericanJournal of Respiratory、Critical Care Medicine、Chest，按纳入和排除标准收集相关的临床随机对照试验。结果：共纳入14篇文献，中英文文献各7篇，共计2603例患者，其中限制性液体管理策略组为1108例，非限制性液体管理策略组为1495例。Meta分析结果显示限制性液体管理不能显著降低急性肺损伤患者的病死率（P=0.13），在非机械通气时间（P0.00001），，ICU住院时间（P0.00001）氧合指数升高（P0.00001），血清乳酸含量下降（P0.00001）方面差异有统计学意义。结论：限制性液体管理不能明显降低急性肺损伤患者的病死率，但可以缩短机械通气时间及ICU住院时间、提高氧合指数、降低血清乳酸含量，仍有必要进行更多大样本、多中心、高质量的RCT研究。
[Abstract]:Objective: to evaluate the effect of different fluid management schemes on the prognosis of patients with acute lung injury and to provide evidence for clinical application. The clinical randomized controlled trials were collected according to the inclusion and exclusion criteria. Results: a total of 2603 patients were included in 14 articles, 7 articles in Chinese and 7 articles in English, including 1108 cases in the restrictive fluid management strategy group, and 1108 cases in the restrictive fluid management strategy group. The results of meta-analysis showed that restrictive fluid management could not significantly reduce the mortality rate of patients with acute lung injury (P0. 13P), and increase the oxygenation index (P 0. 0001), serum lactation during non-mechanical ventilation (P 0. 0001) and ICU hospitalization time (P 0. 0001). Conclusion: restrictive fluid management can not significantly reduce the mortality of patients with acute lung injury. But it can shorten the time of mechanical ventilation and hospitalization of ICU, increase oxygenation index and decrease the content of serum lactic acid, so it is necessary to do more large sample, multi-center and high quality RCT research.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.8

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