连续静脉-静脉血液滤过联合血液灌流对百草枯中毒疗效的meta分析

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1、授予单位代码10089学号或申请号16095中国图书分类号R595.9HebeiMedicalUniversity硕士学位论文学术学位连续静脉-静脉血液滤过联合血液灌流对百草枯中毒疗效的META分析研究生：樊占宏导师：田英平教授专业：急诊医学二级学院：第二医院2018年3月目录中文摘要············································································1英文摘要·································

2、···········································2英文缩写············································································4研究论文连续静脉-静脉血液滤过联合血液灌流对百草枯中毒疗效的META分析前言············································································5材料与方法············

3、······················································6结果············································································7附图···········································································9附表···········································

4、································14讨论···········································································15结论···········································································17参考文献·····························································

5、········18综述百草枯中毒机制及治疗进展············································21致谢·················································································39个人简历···········································································40连续静脉-静脉血液滤过联合血液灌流对百草枯

6、中毒疗效的META分析摘要目的:评价连续静脉-静脉血液滤过联合血液灌流对百草枯中毒的疗效。方法：采用计算机和手工检索Pubmed、EMbase、Cochranelibrary、SinoMed、Webofscience、CNKI和万方数据库，检索时间截止2017年12月31日。收集血液灌流联合连续静脉-静脉血液滤过治疗急性口服百草枯中毒的随机对照实验（RCTs）。纳入数据为病死率、生存时间、呼吸衰竭发生率、循环衰竭发生率。采用Cochrane系统评价法进行纳入文献的2风险评估。应用RevMan5.3分析软件进行

7、Meta分析，采用卡方检验及I进行异质性分析，采用固定模型或随机效应模型计算合并后的综合效应量。结果：纳入符合标准文献6篇，累计样本量1117例，其中血液灌流联合连续静脉-静脉血液滤过（HP+CVVH）组425例，血液灌流（HP）组692例。Meta结果与HP组相比，HP+CVVH可降低3/4d病死率（RR=0.63，95%CI为[0.50,0.79]，P<0.05），对于28/30d病死率(RR=0.81,95%CI[0.59,1.11],P>0.05)、90d病死率(RR=01.05,95%CI[00.8

8、3,1.32],P>0.05)、及总病死率(RR=01.02,95%CI[0.90,1.16],P>0.05)无统计学差异；HP+CVVH可延长患者生存时间（MD=2.82，95%CI为[2.47,3.17],P<0.05），增加呼吸衰竭发生率（RR=2.75，95%CI为[2.18，3.48],P<0.05），降低循坏衰竭发生率（RR=0.40，95%CI为[0.30，0.52],P<0.05）。