【摘要】 目的系统评价全身低温治疗出血性和缺血性脑卒中的有效性和安全性。方法通过计算机检索和人工检索等方法,全面收集有关全身低温治疗脑卒中的随机对照试验(RCT)。对纳入的研究文献进行质量评价,使用RevMan统计软件进行Meta分析。结果有15个随机对照试验符合纳入标准并被录用行Meta分析,分析显示:全身低温可以降低出血性脑卒中的死亡率[OR 0.48,95%CI(0.29,0.79),P=0.004],提高治疗有效性同时不增加肺炎的发生率[OR 1.31,95%CI(0.79,2.17),P=0.3],但是会提高心律失常的发生率[OR 2.62,95%CI(1.04,6.63),P=0.03]。在缺血性脑卒中的治疗中,全身低温并没有降低随访期的死亡率[OR 1.54,95%CI(0.62,3.87),P=0.36],但是会提高肺炎[OR 6.50,95%CI(2.60,16.23),P<0.000 1]和心律失常[OR 4.44,95%CI(1.75,11.26),P=0.002]的发生率,与对照组相比,美国国立卫生研究院卒中量表(NIHSS)评分的差异也不具有统计学意义。结论全身亚低温治疗出血性脑卒中安全有效,治疗缺血性脑卒中疗效不显著,治疗同时应注意相关并发症。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of systemic mild hypothermia therapy in hemorrhagic and ischemic stroke. Methods Through computer searching and manual retrieval,a comprehensive collection of randomized controlled trials( RCT) about systemic mild hypothermia therapy for stroke was established. After quality assessment of these research literatures,statistical software RevMan was used for Meta-analysis. Results Fifteen randomized controlled trials met the inclusion criteria and were used in this meta-analysis. The analysis shows:systemic mild hypothermia could reduce mortality of hemorrhagic stroke [OR 0. 48,95% CI( 0. 29,0. 79),P = 0. 004 ],improve treatment efficacy without increasing the incidence of pneumonia [OR 1. 31,95% CI(0. 79,2. 17),P = 0. 3],but would increase the arrhythmia’ s incidence [OR 2. 62,95% CI(1. 04,6. 63),P = 0. 03]. In the treatment of ischemic stroke,the hypothermia failed to reduce the mortality in follow-up period [OR 1. 54,95% CI(0. 62,3. 87),P = 0. 36]. But increased the incidence of pneumonia [OR 6. 50,95% CI(2. 60,16. 23),P < 0. 000 1]and cardiac arrhythmias [OR4. 44,95% CI(1. 75,11. 26),P = 0. 002]. Difference of National institutes of health stroke scale( NIHSS)score was not obvious compared with the control group. Conclusion The systemic mild hypothermia is safe and effective in treating hemorrhagic stroke,while in ischemic stroke,the efficacy is not significant,and treatment-related complications should be noted.更多还原