| 李鑫,张成鑫,董文鹏,等.围手术期糖皮质激素治疗对小儿心脏手术后临床结果影响的 Meta分析[J].安徽医药,2020,24(3):586-592. |
| 围手术期糖皮质激素治疗对小儿心脏手术后临床结果影响的 Meta分析 |
| Effect of perioperative corticosteroids therapy on clinical outcomes after pediatric cardiac sugery:a meta?analysis |
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| DOI：10.3969/j.issn.1009?6469.2020.03.042 |
| 中文关键词: 糖皮质激素类/治疗应用 心脏外科手术 围手术期 儿童 Meta分析 |
| 英文关键词: Glucocorticoids/therapeutic use Cardiac surgical procedures Perioperative period Child Meta?analysis |
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| 中文摘要: |
| 目的系统评价围手术期糖皮质激素治疗对小儿心脏手术后临床结果的影响。方法计算机检索 PubMed、The Co? chrane Library、Web of Science、中国知网( CNKI)、维普数据库( VIP)、万方数据库( WangFang Data)和中国生物医学文献数据库(CBM)搜集在小儿心脏手术围手术期应用糖皮质激素治疗的随机对照试验和临床对照试验，检索时限均为从建库起至 2018年 8月。由，两位评价员独立筛选文献、提取资料和评价纳入研究的质量后，使用 RevMan 5.3和 Stata 12.0软件进行 Meta分析。结果最终纳入 14项研究。 Meta分析结果显示，围手术期糖皮质激素治疗不能减少小儿心脏术后的死亡率( OR＝0.65， 95%CI:0.22~1.87，P＝0.42)，急性肾损伤发生率( OR＝0.68，95%CI:0.15~2.99，P＝0.61)、机械通气时间( SMD＝-0.08， 95%CI:-0.46~0.30，P＝0.68)和重症监护室住院时间( SMD＝-0.07，95%CI:-0.26~0.12，P＝0.45)。结论当前证据显示围手术期糖皮质激素治疗不能改善小儿心脏手术后的临床结果。 |
| 英文摘要: |
| Objective To systematically review the effects of perioperative corticosteroids therapy on clinical outcomes after pediat? ric cardiac surgery.Methods Databases including PubMed，Cochrane Library，Web of Science，CNKI，VIP，WanFang Data，and CBM were searched for randomized controlled trials and clinical controlled trails of glucocorticoid therapy in children during periop?erative cardiac surgery from its inception to August 2018.Two reviewers independently screened literature，extracted data and as? sessed the quality of included studies；then，meta?analysis was performed by using RevMan 5.3 and Stata 12.0 software.Results Fourteen studies were selected for the final analysis.Meta?analysis showed that corticosteroids could not decrease the incidence ofpostoperative mortality(OR＝0.65，95% CI:0.22 to 1.87，P＝0.42)and acute kidney injury(OR＝0.68，95% CI:0.15 to 2.99，P＝ 0.68).Furthermore，no significant difference was observed between groups in postoperative mechanical ventilation duration(SMD＝ -0.08；95% CI:-0.46 to 0.30；P＝0.68)and intensive care unit length of stay(SMD＝-0.07；95% CI:-0.26 to 0.12；P＝0.45). Conclusion Current evidence suggests that perioperative corticosteroids therapy can not improve the clinical outcomes in pediat?ric patients undergoing cardiac surgery. |
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