纳洛酮在成人心肺脑复苏中的作用评价

目的系统评价纳洛酮在成人心肺脑复苏中的作用。方法计算机检索MEDLINE(1966-2006．6)、EMbase(1984-2006．6)、Cochrane图书馆(2006年第2期)和中国生物医学文献数据库(1978-2006．6)、中国期刊全文数据库(1994-2006．6),纳入纳洛酮治疗心肺脑复苏的随机对照试验(RCT)。由两名研究者独立进行质量评估和交叉核对,并采用RevMan4．2．7软件进行统计分析。结果共纳入10个RCT,研究对象均为年龄在18-75岁的急诊抢救、留观和住院的心搏骤停,需要进行心肺复苏的患者。纳入研究的质量均不高。结果表明纳洛酮联合常规心肺复苏的疗效优于常规心肺复苏。结论纳洛酮联合常规心肺复苏的成功率和神经功能恢复优于常规心肺复苏。但由于纳入研究的质量较差,能够合并的样本例数较少,还需要进行高质量、大样本随机对照试验,才能为临床工作提供充足的证据。

Naloxone for Cardio - Pulmonary - Cerebral Resuscitation:A Systematic Review

Objective To assess the efficacy of naloxone for cardio-pulmonary-cerebral resuscitation (CPCR). Methods Randomized controlled trials (RCTs) involving naloxone for CPCR were identified from MEDLINE (1966 - Jun.2006), EMbase (1974 - Jun.2006), PubMed, The Cochrane Library (Issue2,2006), CBM(1978 - Jun.2006) and CNKI (1994 - Jun.2006). The quality of the trials was assessed by two reviewers independently. RevMan 4.2.7 software provided by the Cochrane Collaboration was used for statistical analysis. Results Ten RCTs were included. The quality of included RCTs was low. All the patients were in-patients or out-patients receiving CPCR due to cardial arrest at the age of 18-75 years. Meta-analysis indicated that the resuscitation rate in naloxone group was significantly higher than the placebo group (P<0.00001). And the recovery of the brain function in naloxone group was better than in the placebo group(P0.00001) Conclusions Naloxone is effective for CPCR and it may ameliorate its prognosis. Because of the low quality of included trials and the small sample size, more RCTs are required to assess the efficacy of naloxone for CPCR.