上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2022 , Vol. 42 >Issue 1: 95 - 100

DOI: https://doi.org/10.3969/j.issn.1674-8115.2022.01.014

论著 · 循证医学

吸入一氧化氮气体对外科手术后肾功能损伤和出血影响的meta分析

  • 钱德伟 ,
  • 周任 ,
  • 关礼春 ,
  • 张航 ,
  • 虞敏
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  • 1.上海交通大学附属第一人民医院心脏及大血管外科，上海 200080
    2.南京医科大学附属南京医院/南京市第一医院心胸血管外科，南京 210006
钱德伟（1995—），男，住院医师，硕士；电子信箱：dwqian2020@163.com。
虞敏，电子信箱：minyudr@163.com。

收稿日期: 2021-04-14

  网络出版日期: 2022-01-28

基金资助

上海申康医院发展中心临床三年行动计划（2020—2022）(SHDC2020CR3100B)

收起

Meta-analysis of impacts of inhaled nitric oxide on postoperative renal injury and hemorrhage

  • Dewei QIAN ,
  • Ren ZHOU ,
  • Lichun GUAN ,
  • Hang ZHANG ,
  • Min YU
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  • 1.Department of Cardiovascular Surgery, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
    2.Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
YU Min, E-mail: minyudr@163.com.

Received date: 2021-04-14

  Online published: 2022-01-28

Supported by

Clinical Research Plan of Shanghai Shenkang Hospital Development Center (2020?2022)(SHDC2020CR3100B)

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摘要

目的·评价吸入一氧化氮（nitric oxide，NO）气体对外科术后肾损伤和出血的影响。方法·系统检索中国知网、中国生物医学文献数据库、万方数据库、PubMed、Embase、Web of Science、Cochrane Library，检索时限为各数据库建库至2021年3月26日。中文以“外科手术”“一氧化氮”为关键词进行检索。英文以“nitric oxide”“surgical procedures，operative”“cardiac surgical procedures”“cardiac surgery”“transplantation”为主题词及自由词进行检索。按照预先制定的纳入及排除标准筛选文献。采用RevMan 5.3软件进行meta分析，观察结局指标为肾损伤发生率和出血发生率。结果·共纳入7篇符合标准的临床研究文献，共计外科患者689例，其中接受NO治疗337例，对照组352例。Meta分析结果显示，相较于对照组，外科手术后应用NO组肾损伤发生率降低，差异有统计学意义（RR=0.75，95% CI 0.61~0.92，P=0.005），而出血发生率差异无统计学意义（RR=0.79，95%CI 0.22~2.83，P=0.710）。结论·外科手术中应用NO不会增加患者的肾损伤和出血风险，且在体外循环手术中应用NO可能具有保护肾脏作用。

关键词： 一氧化氮; 肾损伤; 出血; 外科; meta分析

本文引用格式

钱德伟 , 周任 , 关礼春 , 张航 , 虞敏 . 吸入一氧化氮气体对外科手术后肾功能损伤和出血影响的meta分析[J]. 上海交通大学学报（医学版）, 2022 , 42(1) : 95 -100 . DOI: 10.3969/j.issn.1674-8115.2022.01.014

Abstract

Objective

·To evaluate the effects of inhaled nitric oxide on renal injury and hemorrhage after surgery.

Methods

·China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang Data, PubMed, Embase, Web of Science and The Cochrane Library were searched systematically from the establishment of each database to March 26, 2021. “外科手术” and “一氧化氮” were used as Chinese keywords for retrieval. Correspondingly, the “nitric oxide”“surgical procedures, operative”“cardiac surgical procedures”“cardiac surgery” and “transplantation” were used as subject words and free words for searching. The literatures were screened according to the pre-established inclusion and exclusion criteria. Meta-analysis was performed by using RevMan 5.3. The study end points were the incidences of renal injury and hemorrhage.

Results

·Seven literatures were included for analysis, with a total of 689 surgical patients. Of them, 337 received nitric oxide treatment and 352 received placebo treatment. Compared with the control group, patients treated with nitric oxide demonstrated a statistically difference in reducing the incidence of postoperative renal injury (RR= 0.75, 95%CI 0.61?0.92, P=0.005). There was no significant difference in the incidence of hemorrhage (RR=0.79, 95%CI 0.22?2.83, P=0.710) between the two groups.

Conclusion

·Application of nitric oxide after surgery does not increase the risks of renal injury and hemorrhage. In contrast, the use of nitric oxide in cardiopulmonary bypass might protect renal function.

Key words： nitric oxide; renal injury; hemorrhage; surgery; meta-analysis

参考文献

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