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目的评价大剂量肾上腺素对比标准剂量肾上腺素用于儿童心肺复苏的疗效。方法计算机检索 Medline(1966至2006年)、Embase(1974至2006年)、Cochrane 图书馆2006年第三期、中国生物医学文献光盘数据库(CBM)(1998至2006年)、中文学术期刊全文数据库(1994至2006年)。按纳入排除标准纳入合格的随机对照研究并对其进行质量评价,Meta 分析采用 Rev Man 4.2.7软件进行。结果共纳入4篇研究包括360例,Meta 分析结果表明大剂量肾上腺素与标准剂量的肾上腺素相比用于儿童的心肺复苏在自主循环恢复、24 h 存活率、出院存活率、神经系统后遗症方面无统计学意义,其 RR 值和95% CI 分别为1.28(0.93,1.77)、1.40(0.43,4.55)、1.78(0.42,7.50)、0.72(0.43,1.19)。结论儿童在进行同等心肺复苏条件下,尚不能认为大剂量的肾上腺素可以增加自主循环恢复率、24 h 存活率、出院存活率和减少神经系统后遗症。
Objective To evaluate the efficacy of high-dose epinephrine versus standard-dose epinephrine for cardiopulmonary resuscitation in children. Methods The computer software was used to search Medline (1966-2006), Embase (1974-2006), The Cochrane Library 2006 Third Edition, China Biomedical Literature Disc Database (1998-2006), Chinese Academic Journal Full-text Database 1994 to 2006). Inclusion criteria were included in the eligible RCTs and their quality was evaluated. Meta-analysis was performed using Rev Man 4.2.7 software. Results A total of 4 studies including 360 cases were included. Meta-analysis showed that the high-dose epinephrine compared with the standard dose of epinephrine for children with cardiopulmonary resuscitation in spontaneous circulation recovery, 24 h survival rate, discharge survival rate, neurological sequelae Not statistically significant, the RR and 95% CI were 1.28 (0.93,1.77), 1.40 (0.43,4.55), 1.78 (0.42,7.50), 0.72 (0.43,1.19). Conclusion Children under the condition of equal cardiopulmonary resuscitation, can not be considered a large dose of epinephrine can increase spontaneous circulation recovery rate, 24 h survival rate, discharge survival rate and reduce nervous system sequelae.