控温毯用于热射病患者降温治疗的meta分析

Application of temperature control blanket in cooling treatment of patients with heat stroke:a meta-analysis

目的系统评价控温毯用于热射病降温的效果。方法采用计算机检索The Cochrane Library、Web of Science、PubMed、Ovid、EMBASE、中国知网(CNKI)、维普资讯中文期刊服务平台(VIP)、万方医学网等数据库,搜集控温毯用于热射病患者降温治疗的随机对照试验,检索时限均从建库至2019年6月。由2名研究人员独立筛选文献、提取数据并评价纳入研究的偏倚风险后采用RevMan5.3软件进行meta分析。结果共纳入8篇随机对照试验,438例患者。控温毯降温组患者治疗30 min,1.0、1.5、2.0、3.0 h后体温下降幅度均明显高于常规方法降温组,差异均有统计学意义(均数差=0.47、0.67、1.09、0.58、0.45,95%可信区间:0.28~0.65、0.33~1.01、0.65~1.52、0.10~1.06、0.30~0.59,P=0.001、0.001、0.001、0.020、0.001);控温毯治疗组患者并发症发生率明显低于常规方法降温组,差异有统计学意义(风险比=0.31,95%可信区间:0.18~0.54,P=0.001)。结论联合应用控温毯对热射病患者进行降温治疗优于传统降温方法,有利于快速降温和降低并发症发生率。

Objective To systematically evaluate the effect of temperature control blanket for the temperature decrease of heat stroke.Methods The randomized controlled trials(RCT)on the temperature control blanket for the temperature decrease of heat stroke were retrieved from the databases of Cochrane Library,Web of Science,PubMed,Ovid,EMBASE,CNKI,VIP and Wanfang database by computer.The retrieval time was from the establishment of the databases to June 2019.The two researchers independently screened the literatures,extracted the data and assessed the risk of bias of included studies.The RevMan5.3 software was used to conduct the meta analysis.Results Eight RCTs with 438 patients were included.The temperature decrease range in the temperature control blanket cooling temperature group after 30 min,1.0,1.5,2.0,3.0 h of treatment were significantly higher than those in the conventional method cooling group,and the differences were statistically significant(MD=0.47,0.67,1.09,0.58,0.45;95%CI:0.28-0.65,0.33-1.01,0.65-1.52,0.10-1.06,0.30-0.59;P=0.001,0.001,0.001,0.020,0.001).The complication occurrence rate of the temperature control temperature control group was significantly lower than that of the conventional method cooling group(RR=0.31,95%CI:0.18-0.54,P=0.001).Conclusion The combined application of temperature control blanket for the cooling treatment of the patients with heat stroke is better than the traditional cooling methods,and is conducive to rapidly cooling rate and reduce the occurrence rate of complications.