在移植患者中,平衡晶体与正常盐水相比:更新的系统性审查,元分析和试验序列分析
Lucas Carvalho Pereira1, Igor Carvalho Pereira1, Thamiris Dias Delfino Cabral2
1From the Department of Medicine, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.
Anesthesia and analgesia
|April 5, 2024
概括
与正常盐水相比,平衡的晶体质显著降低了移植患者的延迟移植功能 (DGF). 这种流体管理策略还改善了酸和电解质平衡,改善了患者的治疗结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植 移植 移植 移植
- 关键护理医学 关键护理医学
背景情况:
- 在移植中进行外科手术期间的液体管理是有争议的,特别是在平衡的晶体化物与正常盐水之间.
- 液体选择对酸平衡,电解质水平和临床结果的影响需要进一步研究.
研究的目的:
- 评估平衡晶体溶液与正常盐水相比对移植患者的结局的影响.
- 评估对延迟移植功能 (DGF),酸和电解质平衡以及术后功能的影响.
主要方法:
- 随机对照试验 (RCT) 的系统性审查和元分析,将平衡的低溶液与移植患者的正常盐水进行比较.
- 搜索了MEDLINE,EMBASE和Cochrane数据库;主要结果是DGF.
- 采用了Mantle-Haenszel和DerSimonian和Laird随机效应模型;进行了试验顺序分析 (TSA).
主要成果:
- 纳入了12个与1668名患者的RCT;平衡的晶体化物减少了DGF发生 (RR0.82,P=.005) 样本大小足以通过TSA.证实.
- 与正常盐水相比,平衡的水晶化物显著改善了手术结束时的化物,碳酸,pH和基过剩.
- 在手术后第1天和第7天,研究小组之间的肌素或尿液输出没有显著差异.
结论:
- 平衡的低化物溶液显著降低了移植接受者延迟移植功能的发生率.
- 这些解决方案提供了更好的酸和电解质控制,有助于改善移植的结果.
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