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目的系统评价远程缺血预适应(RIPC)对先心病手术患儿临床结局的影响。方法计算机检索MEDLINE、Science Direct、Elsevier、EMbase、中国生物医学文献数据库、万方数据库等,收集符合纳入标准的研究,检索时限均为从建库至2015年10月,并追溯纳入研究的参考文献和手工检索相关会议资料。由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用Stata 12.0软件进行Meta分析。结果共纳入9个随机对照研究,共697例患儿,meta分析结果显示,RIPC与对照组相比,机械通气时间、ICU住院时间、总住院时间、术后肌钙蛋白水平(c Tn I)、术后24h心肌收缩评分均无显著差异(P>0.05)。结论与现有的成人研究结果不同,本文并未发现RIPC对先心病手术患儿心肌缺血再灌注损伤的保护作用,提示仍需更多高质量RCT去证实RIPC的临床作用。
Objective To systematically evaluate the effect of remote ischemic preconditioning (RIPC) on clinical outcomes in children with congenital heart disease. Methods The data of MEDLINE, Science Direct, Elsevier, EMbase, China Biomedical Literature Database and Wanfang Database were collected by computer, and the search dates were collected from the database to October 2015 and were retrospectively studied. And manually retrieve related conference materials. Two researchers independently screened the literature according to inclusion and exclusion criteria, extracted data and evaluated the quality, and then conducted a Meta-analysis using Stata 12.0 software. Results A total of 9 RCTs were enrolled in this study. A total of 697 children were included in the meta-analysis. The results of meta-analysis showed that compared with the control group, the duration of mechanical ventilation, ICU stay, total length of stay, postoperative cTnI, , 24h after myocardial contraction score was no significant difference (P> 0.05). Conclusion Different from the results of the existing adult studies, this paper does not find the protection of RIPC on myocardial ischemia-reperfusion injury in children with congenital heart disease, suggesting that more high-quality RCT is still needed to confirm the clinical effect of RIPC.