摘要
目的:研究成人心脏手术围术期应用乌司他丁对术后早期认知功能与脑损伤的影响。方法:计算机检索2015年1月至2020年1月期间中国知网、万方数据库、维普数据库及美国国立医学图书馆生物医学信息检索系统(PubMed)、考克兰图书馆(Cochrane Library)等数据库发表的关于成人心脏手术围术期应用乌司他丁对术后早期认知功能及脑损伤影响的随机对照试验,并根据纳入、排除标准筛选文献,提取、归纳其中数据资料,经RevMan5.3软件实施Meta分析。结果:最终纳入文献共8篇,涉及493例患者。以乌司他丁为实验组,生理盐水为对照组。Meta分析显示:实验组术后3,7 d时精神状态检查量表评分高于对照组(P<0.05);实验组术后0.5,6 h时血浆S-100β蛋白及神经元特异性烯醇化酶水平低于对照组(P<0.05);实验组术后0.5,3,12 h时白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)水平低于对照组(P<0.05)。结论:成人心脏手术患者围术期应用乌司他丁的效果理想,可改善术后早期认知功能,减轻脑损伤。
Objective:To study the effects of ulinastatin on the early postoperative cognitive function and brain injury in adult cardiac surgery.Methods:The randomized controlled trials on the effects of ulinastatin on the early postoperative cognitive function and brain damage of adult cardiac surgery published from January 2015 to January 2020 in China HowNet,Wanfang database,Vip database,the National Medical Library Biomedical Information Retrieval System(PubMed),Cochrane Library,etc.were searched.The literatures were screened according to the inclusion and exclusion criteria,the data were extracted and summarized.Meta-analysis was carried out by RevMan5.3 software.Results:A total of 8 articles were finally included,involving 493 patients.Taking ulinastatin as an experimental group and normal saline as a control group,Meta-analysis showed that the mental state examination scale score of the experimental group was higher than that of the control group at 3 d and 7 d postoperatively(P<0.05);after 30 min and 6 h,the plasma S-100βprotein and neuron-specific enolase levels in the experimental group were lower than those in the control group(P<0.05);at postoperation 3 h,and 12 h,the interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the experimental group level were lower than those in the control group(P<0.05).Conclusion:The effect of ulinastatin in perioperative period of cardiac surgery patients is ideal,which can improve early postoperative cognitive function and reduce brain injury.
作者
杨晓凡
葛圣林
张成鑫
高晴云
李艳丽
YANG Xiaofan;GE Shenglin;ZHANG Chengxin;GAO Qingyun;LI Yanli(Department of Cardiovascular Surgery,First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《临床与病理杂志》
2020年第10期2630-2635,共6页
Journal of Clinical and Pathological Research
