摘要
目的通过Meta分析明确主动脉夹层患者发生低氧血症的危险因素。方法检索中英文数据库及纳入文献的参考文献,由2位评价人员按照标准独立筛选文献,提取资料并进行文献质量评价,应用RevMan5.0分析软件对资料进行Meta分析。结果从27篇文献筛选7篇符合纳入标准,样本量为1175例,主动脉夹层发生低氧血症患者为376例,主动脉夹层发生非低氧血症患者为799例,共纳入危险因素63个,仅体重指数(BMI)>25kg/m^2、动脉血氧分压/吸人氧浓度(PaO_2/FiO_2)≤300mmHg、体外循坏时间、机械通气延长、ICU留置时间合并效应量差异有统计学意义,是主动脉夹层发生低氧血症的预测因素;介入治疗是主动脉夹层的保护因素。结论该研究表明,BMI>25kg/m^2、PaO_2/FiO_2≤300mmHg、体外循坏时间、机械通气延长、ICU留置时间是主动脉夹层并发低氧血症的危险因素。术后低氧血症是主动脉夹层的常见并发症,其危险因素受多种因素的影响,仍需更大量前瞻性、高质量的研究进行分析。
Objective To identify the risk factors of hypoxemia in patients with acute aortic dissection by a meta-analysis.Methods Electronic literature databases in Chinese and English and references of included studies were searched.Those studies were independently screened by two evaluation persons in accordance with the standard,the information was extracted,the quality of studies was assessed in term of study design,meta-analysis was conducted by RevMan 5.0.Results Totally 7 studies were identified from 27 papers including 1,175 cases.There were 376 cases of hypoxemia and 799 cases of non-hypoxemia in the patients with aortic dissection.A total of 63 risk factors were involved;only BMI>25 kg/m2,PaO2/FiO2 ratio≤300 mmHg,CPB time,prolonged mechanical ventilation and ICU stay time were identified as the predictive factors for hypoxemia in the patients with acute aortic dissection;and interventional therapy was identified as the protective factor for aortic dissection.Conclusions Our results suggest that BMI>25 kg/m2,PaO2/FiO2 ratio≤300 mmHg,CPB time,prolonged mechanical ventilation,and ICU stay time are the risk factors for hypoxemia in the patients with acute aortic dissection.Postoperative hypoxemia is a common complication in the patients treated by aortic dissection surgery.Its risk factors are affected by many factors.Therefore,a large number of prospective and high-quality studies are still needed.
作者
张欢欢
杨玉金
张加乐
郑春艳
朱剑
李霏
Huan-huan Zhang;Yu-jin Yang;Jia-le Zhang;Chun-yan Zheng;Jian Zhu;Fei Li(Department of Vascular Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China)
出处
《中国现代医学杂志》
CAS
2018年第19期67-74,共8页
China Journal of Modern Medicine
基金
江西省科技计划项目(No:20151BBG70180)
作者简介
通信作者,杨玉金,E-mail:yangyujin6312@163.com。
