颅脑损伤患者发生低钠血症危险因素的Meta分析

AMeta-analysis of Risk Factors for Hyponatremia in Patients with Craniocerebral Injury

目的:系统评价颅脑损伤患者发生低钠血症的危险因素。方法:计算机检索Cochrane图书馆、Pubmed、Embase、Web of Science、CNKI、VIP、CBM、万方数据库等数据库平台自建库起至2022年12月20日有关颅脑损伤患者发生低钠血症危险因素的研究,采用RevMan5.3软件进行Meta分析。结果:共纳入13项原始研究,均为病例对照研究,涉及患者3237例,Meta分析结果表明,年龄[OR=1.03,95%CI(1.01,1.05)]、GCS评分≤8分[OR=3.90,95%CI(2.67,5.70)]、颅骨骨折[OR=3.63,95%CI(2.88,4.58)]、脑水肿[OR=2.88,95%CI(1.81,4.60)]、脑出血[OR=1.80,95%CI(1.44,2.24)]、脑挫裂伤[OR=2.33,95%CI(1.58,3.43)]、穿透性损伤[OR=3.53,95%CI(1.72,7.24)]是颅脑损伤患者发生低钠血症的危险因素。结论:现有证据显示,颅脑损伤后患者发生低钠血症受到各种因素的影响,临床应针对现有的可能危险因素作尽早的干预。

Objective:To systematically evaluate the risk factors of hyponatremia in patients with craniocerebral injury.Method:A computer search was conducted on the risk factors of hyponatremia in craniocerebral injury patients from Cochrane Library,PubMed,Embase,Web of Science,CNKI,VIP,CBM,Wanfang database and other database platforms from self-established databases to December 20,2022.Meta-analysis was performed using RevMan5.3 software.Results:A total of 13 original studies were included,all of which were case-control studies,involving 3237 patients.The results of meta-analysis showed that age[OR=1.03,95%CI(1.01,1.05)],GCS score≤8[OR=3.90,95%CI(2.67,5.70)],skull fracture[OR=3.63,95%CI(2.88,4.58)],cerebral edema[OR=2.88,95%CI(1.81,4.60)],cerebral hemorrhage[OR=1.80,95%CI(1.44,2.24)],cerebral contusion[OR=2.33,95%CI(1.58,3.43)],penetrating injury[OR=3.53,95%CI(1.72,7.24)]is a risk factor for hyponatremia in patients with craniocerebral injury.Conclusion:Existing evidence shows that the occurrence of hyponatremia in patients with craniocerebral injury is affected by various factors,and early clinical intervention should be made according to the existing possible risk factors.