体温保护对接受关节置换术的老年患者术中出血的影响:一项 Meta 分析。

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Alternative therapies in health and medicine Pub Date : 2024-08-01
Wei Zhao, Yang Hu, Xing Wang
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引用次数: 0

摘要

背景:人工关节置换术已成为临床治疗老年退行性终末期骨关节疾病最有效的手段之一。所有并发症均与出血直接或间接相关,而低体温可导致出血,一直是老年患者人工关节置换术中的一个难题:计算机检索Cochrane Library、PubMed、EMbase、Web of Science、CNKI、中国生物医学文献数据库(CBM)、VIP和万方等8个数据库,获取国内外关于体温保护对老年关节置换术患者术中出血影响的对照试验。检索词为 "体温"、"出血 "和 "关节置换术"。检索时间为图书馆建立后至 2022 年 2 月。文献筛选结果通过阅读全文获得,该过程由 2 名研究人员独立完成。经过严格的文献质量评估后,使用 RevMan 5.3 软件进行数据分析:本次荟萃分析最终纳入了 9 项研究。8 项研究报告了试验组和对照组的失血量。荟萃分析表明,试验组的失血量显著低于对照组(SMD:-45.09;95% Cl:-67.76,-22.43;P < .01)。44 项研究显示,试验组输血次数明显低于对照组(OR:0.60;95% Cl:0.39,0.92;P = .01)。3 项研究显示,实验组的术中体温明显高于对照组(SMD:0.60; 95% Cl: 0.20,0.99; P = .003)。4 项研究表明,试验组的术后体温明显高于对照组(SMD:0.83;95% Cl:0.47,1.19;P < .01)。4项研究显示,试验组的颤抖发生率明显低于对照组(OR:0.29; 95% Cl: 0.19,0.46; P < .01):本研究结果表明,从失血量、输血次数、术中体温、术后体温、颤抖发生率、住院时间等方面来看,主动体温保护可能对老年关节置换术患者术中出血有效。
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Effect of Body Temperature Protection on Intraoperative Bleeding in Elderly Patients Undergoing Arthroplasty: A Meta-Analysis.

Background: Artificial joint replacement has become one of the most effective means for the clinical treatment of senile degenerative end-stage bone and joint diseases. All complications were directly or indirectly related to bleeding, and low body temperature can lead to bleeding, which have been a conceren in rthroplasty for elderly patients.

Methods: The computer retrieves eight databases, including Cochrane Library, PubMed, EMbase, Web of Science, CNKI, China Biomedical Literature Database (CBM), VIP and WanFang, to obtain controlled trials at home and abroad on the effects of body temperature protection on intraoperative bleeding in elderly patients undergoing arthroplasty. The search term is "temperature", "bleeding," and "arthroplasty". The search time was from the establishment of the library until February 2022. The literature screening results were obtained by reading the full text, and the process was completed independently by 2 researchers.After a rigorous literature quality evaluation, data analysis was performed using RevMan 5.3 software.

Results: 9 studies were ultimately included in this meta-analysis. 8 studies reported the blood loss of the test group and the control group. Meta-analysis showed that the blood loss of the test group was significantly lower (SMD: -45.09; 95% Cl: -67.76, -22.43; P < .01) than the control group. 44 studies showed that the Number of blood transfusions of the experimental group was significantly lower than the control group (OR:0.60; 95% Cl: 0.39,0.92; P = .01). 3 studies showed that the intraoperative temperature of the experimental group was significantly higher than the control group (SMD:0.60; 95% Cl: 0.20,0.99; P = .003). 4 studies showed that the postoperative temperature of the test group was significantly higher than the control group (SMD: 0.83; 95% Cl: 0.47,1.19; P < .01). 4 studies showed that the shiver incidence of the experimental group was significantly lower than the control group (OR:0.29; 95% Cl: 0.19,0.46; P < .01).

Conclusion: The results of this study suggest that active body temperature protection may be effective on intraoperative bleeding in elderly patients undergoing arthroplasty, as evidenced by blood loss, number of blood transfusions, intraoperative temperature, postoperative temperature, shiver incidence, length of hospital stay.

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来源期刊
Alternative therapies in health and medicine
Alternative therapies in health and medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
0.90
自引率
0.00%
发文量
219
期刊介绍: Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field. Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.
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