早期康复对蛛网膜下腔出血的有效性和安全性评价

发布时间：2018-07-03 14:31

本文选题：早期康复 + 早期活动　；参考：《河南科技大学》2017年硕士论文

【摘要】：目的:系统评价早期康复对蛛网膜下腔出血(subarachnoid hemorrhage,SAH)的有效性和安全性。方法:计算机检索The Cochrane Library(Issue 2,2016)、EMbase、Pubmed、CNKI、VIP、万方数据库和CBM,系统收集关于早期康复对SAH的随机对照试验(RCT)和队列研究(Cohort Study),检索时限均设置为从建库到2016年10月。由2位评价员按照纳入和排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量,采用Re Vman5.3软件进行Meta分析。结果:最终纳入3个研究,共335例患者,早期康复组175例(试验组),未早期康复组(对照组)160例。Meta分析显示:与对照组相比,试验组在治疗期末症状性血管痉挛的发生率明显降低(RR=0.47,95%CI=0.31-0.71,P=0.0004);试验组转归不良的发生率明显小于对照组(RR=0.25,95%CI=0.08-0.75,P=0.01);肺部感染的发生率(RR=0.44,95%CI=0.23-0.86,P=0.01)明显降低;脑积水的发生率无统计学差异(RR=1.08,95%CI=0.39-2.96,P=0.88);且未增加相关死亡风险(RR=0.43,95%CI=0.07-2.50,P=0.35);肺栓塞(RR=1.08,95%CI=0.39-2.96,P=0.88)和下肢静脉血栓(RR=0.82,95%CI=0.11-5.93,P=0.84)发生的风险,试验组与对照组之间无统计学差异。结论:现有证据显示:早期康复有助于降低SAH患者症状性血管痉挛的发生率,降低肺部感染的发生率并改善预后且未增加死亡风险。
[Abstract]:Objective: to evaluate the efficacy and safety of early rehabilitation for subarachnoid hemorrhage. Methods: the Cochrane Library (issue 2n2016) was searched by computer, and the database of CNKIIP, Wanfang database and CBM were searched. The random controlled trial (RCT) and cohort study (Cohort study) of early rehabilitation for SAH were systematically collected. The retrieval time limit was set from the construction of the database to October 2016. According to the inclusion and exclusion criteria, two evaluators independently sifted the literature, extracted the data and evaluated the methodological quality of the study. The Meta-analysis was carried out by re Vman 5.3 software. Results: a total of 335 patients were included in 3 studies, 175 cases in early rehabilitation group (trial group) and 160 cases in non-early rehabilitation group (control group). Meta-analysis showed that: compared with control group, The incidence of symptomatic vasospasm in the trial group was significantly lower than that in the control group at the end of the treatment period (RRN 0.4795 CII 0.31-0.71P0.0004), and the incidence of pulmonary infection (RR0.4495CII 0.23-0.86P0. 01) was significantly lower in the trial group than in the control group (RRR 0.2595CII 0.08-0.75P0. 01). There was no significant difference in the incidence of hydrocephalus (RRN 1.0895 CI 0.39-2.96 P0.88), and there was no increase in the associated risk of death (RRN 0.4395 CI 0.07-2.50 P0.35), pulmonary embolism (RRN 1.0895 CI 0.39-2.96P0.88) and lower extremity venous thrombosis (RRN 0.8295CI 0.11-5.93P 0.84). There was no statistical difference between the trial group and the control group. Conclusion: the available evidence shows that early rehabilitation can reduce the incidence of symptomatic vasospasm, reduce the incidence of pulmonary infection and improve the prognosis without increasing the risk of death in patients with SAH.
【学位授予单位】：河南科技大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.35

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