心肺复苏过程中进行溶栓治疗的Meta分析

Meta-analysis of thrombolysis and non-thrombolysis in cardiopulmon ary resuscitation

目的根据现有临床研究评价对心肺复苏过程中进行溶栓治疗的有效性和安全性。方法从1966-01-01-2004-08-01MEDLINE光盘数据库,检索以心跳骤停后进行心肺复苏术的患者为研究对象,比较溶栓与非溶栓治疗效果的临床研究文献,并对文献结果进行Meta分析。结果共9篇临床研究文献入选。心肺复苏过程中进行溶栓治疗可以显著提高自主循环恢复率、24小时存活率、出院率并改善远期神经功能(P<0·01)。相比非溶栓治疗,溶栓治疗显著增加了严重性出血的发生率(P<0·01)。结论与非溶栓治疗比较,溶栓治疗增加了的严重性出血的发生率。但从整体而言,心肺复苏术过程中进行溶栓治疗可以显著提高患者的出院率并改善远期神经功能。

Objective To evaluate the efficacy and safety of thrombolysis in cardiopulmonary resuscitation （CPR）.Methods The efficacy or safety of thrombolysis and non- thrombolysis in CPR were chosen and compared from MEDLINE disks from 1966 to August of 2004. A Meta-analysis was applied to evaluate the results of the two therapies. Results Nine clinical thesises were analyzed. Compared with non-thrombolysis, the rate of spontaneous circulation return, survival time more than 24-hours, survival to discharge and improved neurological function in patients with CPR treated with thrombolysis were significant higher （P 〈 0.01 ）, but the rate of major bleeding was higher too. Conclusion Thrombolysis increases the risk of major bleeding, but it could markly improve the rate of survival to discharge and improve neurological function in patients with CPR on the whole.