平衡盐液和生理盐水对重症患者综合效果的Meta分析

doi:10.3969/j.issn.1002-1949.2019.02.012

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摘要目的采用Meta分析比较平衡盐液和生理盐水对重症患者的综合效果。方法应用计算机检索美国国立医学图书馆PubMed数据库、Cochrane数据库、万方数据库、中国知网，收集比较平衡盐液和生理盐水综合效果的随机对照临床试验（RCT）。研究对象为重症患者，检索时限为建库至2018年4月。由2名评价者按照纳入与排除标准选择文献、提取资料和评价质量后，采用RevMan 5.3软件进行Meta分析。结果初筛共获得160篇文献，剔除重复文献及不符合纳入标准文献后，共纳入4项研究19 105例患者，平衡盐液组9647例，生理盐水组9458例。Meta分析显示，两组患者ICU病死率比较差异无统计学意义（RR0.91,95%CI0.82～1.01，P=0.09）；肾脏替代治疗（RRT）使用率比较差异无统计学意义（RR1.03,95%CI 0.61～1.75，P=0.91）；急性肾损伤（AKI）2级及以上发生率比较差异无统计学意义（RR0.93,95%CI0.85～1.01，P=0.07）；住院30 d病死率（RR0.93,95%CI 0.85～1.01,P=0.08）、住院60 d病死率(RR0.94,95%CI0.87～1.02,P=0.13)比较差异无统计学意义。漏斗图分析结果显示，未见发表偏倚。结论与生理盐水比较，重症患者应用平衡盐液，不能降低住院病死率、RRT使用率、AKI 2级及以上发生率。

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	龚菊
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关键词 ：平衡液, 氯化钠, 危重患者医疗, Meta分析

通讯作者: 黄晓文（1979-），男，副主任中医师，E-mail：tcmhuang@sina.com。

作者简介: 龚菊（1982-），女，硕士，副主任医师,E-mail：44707879@qq.com。

引用本文:

龚菊，黄晓文，张碧波，李斌，张凌. 平衡盐液和生理盐水对重症患者综合效果的Meta分析[J]. 中国急救医学, 2019, 39(2): 156-160.
Gong Ju, Huang Xiao-wen, Zhang Bi-bo, Li Bin, Zhang Ling. Comprehensive effect of balanced crystalloids or saline in critically ill patients: a Meta-analysis. Chinese Journal of Critical Care Medicine, 2019, 39(2): 156-160.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.02.012 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I2/156

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