早期气管切开对重型颅脑损伤患者预后影响的Meta分析

发布时间：2018-08-23 12:02

【摘要】：目的评价早期气管切开与延迟气管切开对重型颅脑损伤患者预后的影响。方法计算机检索Conchrane Library、PubMed、Embase、OVID、CBM、CNKI、万方和维普数据库中关于早期气管切开对重型颅脑损伤患者预后影响的随机对照试验(RCT),检索时限由建库至2016年3月,同时查阅所获取的参考文献索引。两名研究者对检索收集到的文献按照制订的纳入、排除标准进行独立筛选。以呼吸机相关性肺炎(VAP)发生率,机械通气时间,ICU住院时间、病死率作为评价指标。对纳入文献进行方法学质量评价,采用Review Manager 5.3软件进行Meta分析。结果最终纳入4篇随机对照研究,共220例患者。Meta分析结果显示:早期气管切开对颅脑损伤患者的VAP发病率(P=0.15)及病死率(P=0.20)差异无统计学意义,但对机械通气时间(P=0.01)及ICU住院时间(P=0.05)差异均有统计学意义。结论早期气管切开不能降低重型颅脑损伤患者VAP发病率及病死率,但能减少机械通气时间和ICU住院时间。
[Abstract]:Objective to evaluate the effect of early tracheotomy and delayed tracheotomy on the prognosis of patients with severe craniocerebral injury. Methods computer search was performed for the Conchrane Library Conchrane Embase (OVIDC) (RCT), the (RCT), retrieval time of the randomized controlled trial (RCT),) about the influence of early tracheotomy on the prognosis of patients with severe craniocerebral injury in Wanfang and Weip databases, and the index of references obtained were also consulted. The two researchers independently screened the collected literature according to the established inclusion and exclusion criteria. The incidence of ventilator-associated pneumonia (VAP), the duration of mechanical ventilation and the length of hospitalization and mortality were used as indicators. The methodological quality of the literature was evaluated and the Meta analysis was carried out with Review Manager 5.3 software. Results four randomized controlled trials were conducted. The results of Meta-analysis showed that there was no significant difference in the incidence of VAP (P0. 15) and mortality (P0. 20) in patients with craniocerebral injury by early tracheotomy. But there were significant differences in mechanical ventilation time (P0. 01) and ICU hospitalization time (P0. 05). Conclusion early tracheotomy can not reduce the incidence and mortality of VAP in patients with severe craniocerebral injury, but it can reduce the time of mechanical ventilation and the hospitalization time of ICU.
【作者单位】：重庆医科大学附属永川医院重症医学科;
【基金】：重庆市永川区科技划项目(YCSTC2012BE5008)
【分类号】：R651.15

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