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右美托咪啶在冠状动脉旁路移植围术期中作用效果的荟萃分析
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Journal Article
右美托咪啶在冠状动脉旁路移植围术期中作用效果的荟萃分析
2014
Overview
目的评价右美托咪啶在冠状动脉旁路移植术（CABG）围术期中的作用效果。方法计算机检索Cochrane图书馆、Pub Med、EMBase、Highwire、Medline、CBM、CNKI、CSJD等中外生物医学数据库,收集关于右美托咪啶在CABG围术期中应用的随机对照试验。按Cochrane系统评价方法,评价所纳入研究的文献质量,提取有效数据后采用Rev Man 5.0软件进行Meta分析。结果纳入10项研究,共计562例患者。Meta分析显示,与对照组比较,右美托咪啶注射液治疗组患者机械通气时间明显减少（RR=–2.26,95%CI–4.44~–0.07,P=0.04）,室性心动过速发生率明显降低（RR=0.21,95%CI 0.09~0.53,P=0.0009）,谵妄发生率明显降低（RR=0.53,95%CI 0.29~0.98,P=0.04）,而ICU时间（RR=–0.27,95%CI–0.56~0.02,P=0.06）、病死率（RR=0.77,95%CI 0.20~3.05,P=0.71）、心动过缓（RR=1.46,95%CI0.88~2.44,P=0.14）、低血压（RR=1.55,95%CI 0.98~2.46,P=0.06）、合并应用升压药物（RR=0.99,95%CI 0.56~1.76,P=0.98）及房颤（RR=0.82,95%CI 0.58~1.17,P=0.27）等方面两组比较差异无统计学意义。结论 CABG围术期应用右美托咪啶治疗可明显减少机械通气时间及室性快速性心律失常、谵妄的发生,且不增加并发症的发生率,可改善患者预后。
