外腔室排水的快速与逐渐断奶:一个系统的文献综述和元分析
Florian Ebel1, Eric Lichter2, Luigi Mariani3,2
1Department of Neurosurgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. florianmarc.ebel@usb.ch.
Neurocritical care
|June 12, 2023
概括
快速的外腹腔排水 (EVD) 断奶对于防止腹腔关节 (VPS) 插入,与逐渐断奶一样有效. 快速断奶也大大减少了住院和重症监护室 (ICU) 停留时间.
科学领域:
- 神经外科 神经外科
- 临界护理医学 临界护理医学
- 基于证据的医学基于证据的医学.
背景情况:
- 外腔室排水 (EVD) 插入是一种常见的神经外科手术程序.
- 最佳的EVD断奶策略,以最大限度地减少腹腔关节 (VPS) 插入,仍然不清楚.
研究的目的:
- 系统地审查和分析比较逐渐与快速EVD断奶的研究.
- 评估断奶方法对VPS插入率和患者结果的影响.
主要方法:
- 在PubMed/Medline,Embase和Web of Science数据库中的系统文献搜索.
- 四项研究 (1337名患者) 的元分析,比较了逐渐和快速的EVD断奶.
- 主要结果:VPS插入率. 二次结局:与埃博拉病毒相关的感染 (EVDAI),停留时间 (LOS).
主要成果:
- 在逐渐 (28.1%) 和快速 (32.1%) EVD 断奶之间,VPS 插入率没有显著差异 (RR 0.85,p=0.56).
- 两组之间可比的EVD相关感染率 (EVDAI) (渐进的11.2%,快速的11.5%,RR0.67,p=0.45)
- 在快速断奶组 (p<0.01) 的ICU (2.7天) 和医院 (3.6天) 的LOS显著缩短 (p<0.01).
结论:
- 快速EVD断奶是一种可行的替代逐步断奶,具有类似的VPS插入率和EVDAI.
- 快速断奶显著减少了住院和ICU停留时间.
- 这表明对资源利用和患者康复有潜在的好处.
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