摘要
目的评价围手术期应用极化液治疗对冠状动脉搭桥术患者早期预后的影响。方法计算机检索Cochrane图书馆（2011年第3期）、PubMed、EMBase、MEDLINE、Highwire、CBM、CNKI等中外生物医学数据库，收集关于行冠状动脉搭桥术患者围手术期应用极化液治疗的随机对照试验，检索日期由2000年1月至2011年12月。按Cochrane系统评价方法，评价所纳入研究的文献质量，并提取有效数据后采用RevMan5．0软件进行meta分析。结果纳入9项研究，共计1029例患者。Meta分析显示：围手术期应用极化液治疗可降低患者术后心肌梗死发生率（RR=0．59，95％CI：0．38～0．91，P=0．02），显著降低正性肌力药物使用率（RR=0．44，95％CI：0．35—0．56，P〈0．01），亦可增加术后心房颤动发生率（职=1．23，95％C，：1．05-1．43，P：0．009），但对重症监护病房滞留时间（WMD=-1．47，95％CI：-5．91～2．96，P：0．51）没有影响。结论围手术期应用极化液治疗可减少行冠状动脉搭桥术患者早期心肌损伤并改善心功能，但可增加术后房颤发生率。
Objective To assess the effect of perioperative glucose-insulin-potassium （GIK） infusions on the prognosis in patients undergoing coronary artery bypass grafting. Methods Electronic databases including Cochrane library （Issue 3, 2011 ） , Pubmed, EMbase, Highwire, CBM and CNKI were searched. A meta-analysis of all randomized controlled trials （RCTs） comparing GIK with control in coronary artery bypass grafting was performed. Study selection and meta-analysis were conducted which according to the Cochrane Handbook for systematic reviews. Date were extracted from these trials by 3 reviewers independently and analyzed by RevMan5. 0 software. Results A total of 9 RCTs including 1029 patients were assessed in this study. GIK infusion was associated with significantly fewer perioperative myocardial infarctions （ RR = 0. 59,95% CI： 0. 38-0. 91, P = 0. 02 ） , less inotropie support requirement （RR =0. 44,95% CI：0. 35-0. 56, P 〈0. 01 ）,and increase the incidence of postoperative atrial fibrillation （RR = 1.23,95% CI： 1.05-1.43, P = 0. 009 ）. Conclusions GIK significantly reduces myocardial injury and improves cardiac function in patients undergoing coronary artery bypass grafting, but also increases the incidence of postoperative atrial fibrillation.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2012年第11期1021-1026,共6页
Chinese Journal of Surgery
基金
新疆维吾尔自治区重点学科项目（新教研2010-7号）
关键词
冠状动脉分流术
手术期间
葡萄糖
胰岛素
钾
预后
META分析
Coronary artery bypass
Intraoperative period
Glucose
Insulin
Potassium
Prognosis
Meta-analysis
