摘要
目的评价早期气管切开与延迟气管切开对重型颅脑损伤患者预后的影响。方法计算机检索Conchrane Library、PubMed、Embase、OVID、CBM、CNKI、万方和维普数据库中关于早期气管切开对重型颅脑损伤患者预后影响的随机对照试验(RCT),检索时限由建库至2016年3月,同时查阅所获取的参考文献索引。两名研究者对检索收集到的文献按照制订的纳入、排除标准进行独立筛选。以呼吸机相关性肺炎(VAP)发生率,机械通气时间,ICU住院时间、病死率作为评价指标。对纳入文献进行方法学质量评价,采用Review Manager 5.3软件进行Meta分析。结果最终纳入4篇随机对照研究,共220例患者。Meta分析结果显示:早期气管切开对颅脑损伤患者的VAP发病率(P=0.15)及病死率(P=0.20)差异无统计学意义,但对机械通气时间(P=0.01)及ICU住院时间(P=0.05)差异均有统计学意义。结论早期气管切开不能降低重型颅脑损伤患者VAP发病率及病死率,但能减少机械通气时间和ICU住院时间。
Objective To evaluate the effects of early tracheotomy and delay tracheotomy on the prognosis of patients with severe craniocerebral injury.Methods Data of randomized controlled test（RCT）of early tracheotomy on the prognosis of the patients with severe craniocerebral injury were retrieved by using Conchrane Library,PubMed,Embase,OVID,CBM,CNKI,Wanfang and VIP database.The retrievaled time was limited from their building to March 2016,and all the index of the obtained references was accessed.Two researchers independently screened the literature in accordance with the established criteria for inclusion or exclusion.The incidence of VAP,mechanical ventilation time and ICU length of hospital stay,mortality were considered as evaluation indexes.The methodology quality of the included references was evaluated,and the Meta-analysis was performed by using Review Manager 5.3software.Results Finally,4randomized controlled studies（RCT）were enrolled,including 220 patients.Meta-analysis results showed that：early tracheotomy did not have any effects on VAP incidence rate（P=0.15）and fatality rate（P=0.20）of the patients with severe craniocerebral injury,there was not any statistically difference;but there was a statistically difference between the mechanical ventilation（P=0.01）and ICU hospitalization time（P=0.05）.Conclusion Early tracheostomy could not significantly reduce the incidence of VAP and fatality rate of the patients with severe craniocerebral injury,but it can reduce the mechanical ventilation time and ICU hospitalization time.
出处
《重庆医学》
CAS
北大核心
2017年第5期654-657,共4页
Chongqing medicine
基金
重庆市永川区科技划项目(YCSTC2012BE5008)
关键词
气管切开
颅脑损伤
预后
META分析
tracheotomy
traumatic brain injury
the prognosis
Meta analysis
