体外序贯双除颤对顽固性室颤患者自主循环恢复影响的Meta分析

A meta-analysis of the effect of double sequential external defibrillation on return of spontaneous circulation in the patients with refractory ventricular fibrillation

目的系统评价体外序贯双除颤(DSED)对顽固性室颤患者自主循环恢复(ROSC)的影响。方法检索中英文数据库Web of science、EMBASE、Medline及万方数据库、中国学术期刊全文数据库、中国生物医学文献数据库等,筛选发表至2022年3月的顽固性室颤使用DSED的观察性研究和随机对照研究。结果共纳入5篇文献,其中1篇为随机对照研究,4篇为观察性研究。纳入1152例院外心脏骤停(out-of hospital cardiac arrest,OHCA)顽固性室颤患者,其中272例接受DSED,880例接受标准除颤。DSED组和标准除颤组患者ROSC分别为33.1%和39.0%,OR=0.75(95%CI 0.55~1.01,P=0.06),室颤终止分别为51.5%和53.6%,OR=0.74(95%CI 0.55~1.00,P=0.05)。两组患者入院时存活率和出院时存活率差异无统计学意义。结论DSED未增加顽固性室颤患者ROSC成功率。

Objective To systematically evaluate the effect of double sequential external defibrillation(DSED)on return of spontaneous circulation(ROSC)in the patients with refractory ventricular fibrillation.Methods Randomized controlled studies and observational studies published before March 2022,which reported the treatment of DSED on ROSC,were screened from Chinese and English databases including Web of Science,EMBASE,Medline,Wanfang Database,CNKI,and CBM.Results Five studies were included,including 1 randomized controlled study and 4 observational studies.A total of 1152 patients with refractory ventricular fibrillation after out-of-hospital cardiac arrest(OHCA)were enrolled,of whom 272 received DSED and 880 received standard defibrillation.ROSC in DSED group and standard defibrillation group were 33.1%and 39.0%,OR=0.75(95%CI 0.55-1.01,P=0.06),and termination of ventricular fibrillation were 51.5%and 53.6%,OR=0.74(95%CI 0.55-1.00,P=0.05),respectively.There were no differences in admission survival and discharge survival between the two groups.Conclusions DSED did not increase the success rate of ROSC in the patients with refractory ventricular fibrillation.