亚低温治疗对儿童心脏骤停患者预后的Meta分析

Prognostic Significance of Therapeutic Hypothermia in Children after Cardiac Arrest:a Meta-Analysis

目的:分析儿童心脏骤停患者接受亚低温治疗的预后情况。方法:计算机检索PubMed、Web of Science、Embase三大数据库,查找亚低温治疗儿童心脏骤停患者的相关研究,检索时限至2018年2月。采用Jadad量表对纳入的文献进行质量评价,采用Revman 5.0进行Meta分析。结果:亚低温与常规温度治疗相比,死亡率(OR=0.71,95%CI:0.54～0.94,P=0.02)有统计学意义,心律失常发生率(OR=1.12,95%CI:0.82～1.54,P=0.46)、细菌阳性培养率(OR=1.26,95%CI:0.94～1.68,P=0.12)、一年生存率(OR=1.32,95%CI:0.97～1.80,P=0.08)及输血率(OR=1.11,95%CI:0.78～1.57,P=0.56)均无统计学差异。结论:亚低温治疗能有效降低心脏骤停患儿的死亡率,而一年生存率、心律失常发生率、细菌阳性培养率及输血率均无改善。

Objective:To analyze the prognostic significance of hypothermia in children after cardiac arrest.Methods:A systematic literature retrieval was conducted via searching from the databases of PubMed,Web of Science,and Embase up to Feb 2018.Evidence quality was evaluated with Jadad quality scale,and meta analysis was conducted by Revman5.0.Results:Therapeutic hypothermia can remarkably decrease the mortality(OR=0.71,95%CI:0.54 to 0.94,P=0.02),but there was no significant decrease in incidence of arrhythmias(OR=1.12,95%CI:0.82 to 1.54,P=0.46),bacterial positive culture rate(OR=1.26,95%CI:0.94 to 1.68,P=0.12),one-year survival rate(OR=1.32,95%CI:0.97 to 1.80,P=0.08)and the ratio of blood component transfusion(OR=1.11,95%CI:0.78 to 1.57,P=0.56)when compared to the control group.Conclusion:Therapeutic hypothermia can decrease mortality significantly in pediatric cardiac arrest.While it shows no improvement in one-year survival rate,incidence of arrhythmias,bacterial positive culture rate and the ratio of blood component transfusion.