急性大出血患者输注血小板联合冷沉淀疗效的Meta分析

Meta-analysis of the efficacy of platelet associated with cryoprecipitate transfusion in patients with acute massive hemorrhage in China

目的系统评价急性大出血患者输注血小板联合冷沉淀的临床疗效。方法通过万方医药期刊数据库(wanfang)、中国生物医学文献数据库(CBM)、维普中文科技期刊全文数据库(VIP)及中国期刊全文数据库(CNKI)检索2005~2016年公开发表的中文文献,同时辅以其他的检索,收集同期未发表的中文文献资料(包括会议论文、学术报告、毕业论文等)。按照严格的纳入/排除标准筛选符合标准的文献7篇,采用Cochrane协作网推荐的方法评价文献质量,并采用Cochrane协作网提供的RevMan5.3软件进行Meta分析。结果根据Cochrane协作网推荐的评价方法,7篇文献评价均为B或C级,为低质量研究。Meta分析显示,在凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)和纤维蛋白原(Fbg)这4个指标体现的凝血功能方面,实验组都比对照组疗效更加明显,血小板(PLT)不明显。结论与单独的血小板输注或者冷沉淀输注相比,血小板联合冷沉淀输注对于大出血患者的疗效更加明显。

Objective To assess the efficacy of platelet associated with cryoprecipitate transfusion in patients with acute massive hemorrhage. Methods Articles have been searched from WANFANG Database, Chinese biomedicine Literature Database（CBM）, CQVIP, and CNKI. Database in the years 2005 to 2016. In addition, theses had been obtained from documents unpublished, such as conference papers, academic report and graduation thesis. There are 7 documents to accord with included-standard, which are graded according to the Cochrane Collaboration＇s method. 7 studies meeting the criteria were subjected to a meta-analysis using the RevMan 5.3 software developed by the Cochrane Collaboration. Results According to the Cochrane Collaborationrs method, 7 trials receive a class of B-C and have a low level of evidence. A meta-analysis showed： In the thrombin time （TT）, prothrombin time （PT）, activated partial thromboplastin time （APTT） and fibrinogen （FBG） reflect the four index of coagulation function, the experimental group are compared with the control group, the therapeutic effect is more obvious but the platelet （PLT） is not obvious. Conclusion Compared to the single platelet group or cryoprecipitate group, the efficacy of test group is more obvious.