应用零平衡超滤对患者围术期影响的荟萃分析

The effects of zero-balance ultrafiltration on postoperative recovery after cardiopulmonary bypass: a systematic review

目的希望能够通过系统评价的方式对零平衡超滤(Z-BUF)随机对照研究进行临床效果分析。方法由三人广泛检索成人和小儿Z-BUF相关随机对照研究,检索了英文数据库(PubMed,Embase,the Cochrane Library,Google scholar)和中文数据库(中国知网、万方、维普)。采用RevMan5.1软件进行Meta分析,对不能合并的研究进行描述性分析。结果一共入选6项研究。成人组中,Z-BUF组和非超滤组在机械通气时间和ICU时间上并无统计学差异。小儿组中仅入选一篇文献,显示Z-BUF组可以减少机械通气时间和ICU时间。入选的6篇文献中1篇文献报道有1例死亡病例。结论分析结果认为Z-BUF临床应用的优势并不明显,仍需要进一步研究。

Objective To conduct a meta-analysis to evaluate clinical effect of zero-balance uhrfiltration （Z-BUF） by screen- ing all relevant randomized clinical trial （RCTs） published. Methods Comprehensive search was conducted to screen all randomized controlled trials of Z-BUF for adults and children. Three trained investigators searched database including PubMed, Embase, the Co- ehrane Library, Google scholar, and Chinese literature databases （CNKI, WanFang, WeiPu）. The RCTs that compared Z-BUF with non-ultra_filtration were included. RevMan5.1 was used to analysis all statistical data. Studies that could not be combined were analyzed descriptively. Results A total of 6 studies accorded with included criteria and were divided into adult group and pediatric group. Ran- dom effects model was used to calculate weighted mean difference with 95% colffidence intervals. In adult group, benefits of Z-BUF in duration of ventilation and the length of ICU were not apparent with significant heterogeneity existing in statistical results. The rest of clinical parameters could not be evaluated due to the lack of enough data. In pediatric group, only one study was included and revealed reduction of ventilation time and the length of ICU. Conclusion The benefits of Z-BUF are not apparent according to the reports. Fur- ther studies involving combined ultrafihration are expected to provide the best ultrafiltration way during CPB.