發(fā)布時(shí)間：2018-03-27 08:09

  本文選題：急性心肌梗死　切入點(diǎn)：氧療　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的系統(tǒng)評(píng)價(jià)急性心肌梗死后早期氧療的療效。方法計(jì)算機(jī)檢索PubMed、EMbase、The Cochrane Library(2015年第11期)和CBM數(shù)據(jù)庫,搜集急性心肌梗死后早期氧療的相關(guān)隨機(jī)對(duì)照試驗(yàn)(RCT),檢索時(shí)限均從建庫至2015年11月。由2名評(píng)價(jià)者獨(dú)立篩選文獻(xiàn)、提取資料并評(píng)價(jià)納入研究的偏倚風(fēng)險(xiǎn)評(píng)價(jià)后,采用Rev Man 5.3軟件進(jìn)行Meta分析。結(jié)果共納入7個(gè)RCT,共1388例患者。Meta分析結(jié)果顯示:氧療組和空氣組患者的病死率[OR=1.12,95%CI(0.57,2.20),P=0.75]、主要心血管事件發(fā)生率(MACCE)[OR=1.00,95%CI(0.46,2.18),P=1.00]、住院期間發(fā)生心律失常發(fā)生率[OR=1.01,95%CI(0.45,2.24),P=0.98]和心源性死亡發(fā)生率[OR=0.53,95%CI(0.17,1.69),P=0.28]的差異均無統(tǒng)計(jì)學(xué)意義。但氧療組的再發(fā)心肌梗死發(fā)生率明顯高于對(duì)照組[OR=5.73,95%CI(1.47,22.31),P=0.01],平均住院時(shí)間明顯長于對(duì)照組[MD=1.28,95%CI(1.10,1.47),P0.00001],且差異具有統(tǒng)計(jì)學(xué)意義。結(jié)論氧療用于治療急性心肌梗死療效不明確且有增加再發(fā)心肌梗死、延長平均住院時(shí)間的可能。受納入研究數(shù)量和質(zhì)量限制,上述結(jié)論尚需開展更多高質(zhì)量研究予以驗(yàn)證。
[Abstract]:Objective to evaluate the efficacy of early oxygen therapy after acute myocardial infarction (AMI). Methods the Cochrane Library (issue 11 of 2015) and CBM database were searched by computer. A randomized controlled trial of early oxygen therapy after acute myocardial infarction (AMI) was collected. The retrieval time was from the establishment of the database to November 2015. Two evaluators independently screened the literature, extracted the data and evaluated the bias risk assessment that was included in the study. Rev Man 5.3 software was used to carry out Meta analysis. Results the results of Meta analysis included 7 RCTs and 1388 patients. The results showed that the mortality rate of patients in oxygen therapy group and air group [OR1.1295CI0.572.20], the incidence of major cardiovascular events was MacCE0.75] [OR1.0095CI0.46V2.18P0. 00], arrhythmias occurred during hospitalization. The incidence of recurrent myocardial infarction in the oxygen therapy group was significantly higher than that in the control group [OR5.795 CI1.4777.22.31] and the average hospitalization time was significantly longer than that in the control group [MD1.28995 CI 1.101.47P0.00001], but the incidence of recurrent myocardial infarction in the oxygen therapy group was significantly higher than that in the control group (OR5.795CI1.477.22.31P0. 01), and the incidence of cardiogenic death was not significantly different from that of the control group [OR0.5395 CII 0.171.69], and the difference was statistically significant in the oxygen therapy group (Or5.795 CI1.4795 CI1.477.22.31P0. 01), and the average hospital stay was significantly longer than that in the control group (MD1.2895CII 1.101.47P0.00001). Conclusion oxygen therapy is not effective in the treatment of acute myocardial infarction and can increase the recurrence of myocardial infarction. The possibility of prolonging the average length of stay is limited by the quantity and quality of the studies included, and these conclusions need to be verified by more high-quality studies.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R542.22

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本文編號(hào)：1670707