围术期不同水化治疗方案对预防支架置入术后对比剂肾损伤的Meta分析

Meta analysis of the effect of different hydration therapy on the prevention of contrast-induced acute kidney injury after stent implantation

目的:对围术期不同水化治疗方案预防支架置入术后患者对比剂肾损伤疗效进行Meta分析,系统评价多种水化治疗方案预防支架置入术后患者对比剂肾损伤发生的效果并给出最优的干预方案。方法:计算机检索PubMed、EMbase、Cochrane Library、中国知网、万方、维普和中国生物医学数据库,纳入国内外有关水化治疗的不同干预方法对于支架置入术后患者对比剂肾损伤疗效的临床研究文献,检索时限均从建库至2021年12月31日,收集符合要求的随机对照试验(RCT)文献,运用Cochrane系统评价的方法,使用RevMen5.4软件对研究结果进行Meta分析。结果:最终共纳入5篇文献,总计988例支架置入病例,结果显示围术期静脉水化治疗对于预防对比剂肾损伤的效果优于围术期口服水化治疗,总有效率(RR=0.59,0.95%CI:0.40~0.87,Z=2.70,P=0.007)差异有统计学意义。结论:相对于围术期单纯口服水化治疗,围术期静脉水化治疗可更好地减少支架置入术后患者对比剂肾损伤的发生率。

Objective:Meta-analysis aimed to evaluate the effects of perioperative hydration treatment on contrast-induced acute kidney injury in patients after stent implantation.The effects of various hydration treatments on the prevention of contrast-induced acute kidney injury in patients after stent implantation were systematically evaluated,and the optimal intervention scheme was given,Methods:PubMed,EMBASE,Cochrane Library,WAN FANG,CBM,CNKI,and other databases were searched by computer to include the clinical research literature on the efficacy of different intervention methods of hydration treatment on Contrastinduced acute kidney injury in patients after stent implantation.The retrieval time was from the build database to December 31,2021.The literature of randomized controlled trials(RCT)meeting the requirements was collected,Using the Cochrane system evaluation method and revmen5.4 software,the research results were meta-analyzed.Results:Finally,five pieces of literature were included,and a total of 988 cases of stent implantation were enrolled.The results showed that the effect of perioperative intravenous hydration therapy on the prevention of contrast-induced acute kidney injury was better than perioperative oral hydration therapy.The total effective rate was(RR=0.59,0.95%CI:0.40-0.87,Z=2.70,P=0.007).Conclusions:Compared with perioperative oral hydration therapy,perioperative intravenous hydration therapy can better reduce the incidence of contrast-induced acute kidney injury in patients after stent implantation。