纳洛酮在心肺复苏中疗效的系统评价

目的 评价纳洛酮在心肺复苏中的疗效.方法 计算机检索中国期刊全文数据库、中文科技期刊全文数据库、数字化期刊全文数据库、中国生物医学文献数据库、EMBASE、PubMed、Cochrane Library、SCI等并辅以手工检索,按照纳入标准,两名研究者独立筛选文献并提取资料,采用Jadad评分标准评价纳入文献的质量,采用RevMan5.0软件进行统计学处理.结果 纳入14篇文献(953例患者).Meta分析结果显示,纳洛酮联合常规心肺复苏在复苏成功率(P<0.00001)、自主循环恢复成功率(P=0.0001)、自主呼吸恢复成功率(P<0.00001)、从呼吸心跳恢复到脑复苏的时间(P<0.00001)等方面均有统计学意义.结论 纳洛酮对部分患者可以提高心肺复苏的成功率,并有促进脑复苏作用.由于纳入研究样本的地域性限制,尚需要高质量、大样本、多中心的随机双盲对照试验加以证实.

Naloxone for cardiopulmonary resuscitation:a systematic review

Objective To systematically evaluate the curative effect of naloxone used in cardiopulmonary resuscitation for the patients with cardiac arrest. Methods According to selection criteria, we searched randomized controlled trials or quasi-randomized controlled trials in Chinese Scientific Journals Full-text Database, China Journal Full-text Database, Chinese Biomedicine Database, WanFang Database, PubMed, Cochrane Library, EMBASE and SCI. Quality assessment and data extraction were done by two reviewers independently according to the standard of Jadad score. Meta-analysis was carried on as the results of homogenous studies by RevMan 5.0 software. Results We included fourteen studies (953 patients). There were statistical significance in the success rate of cardiopulmonary resuscitation (P<0.00001), spontaneous circulation recovery (P=0.0001), spontaneous breathing recovery (P<0.00001)and the time from respiratory and heart recovery to brain recovery(P<0.00001). Conclusion Naloxone reduces the time from respiratory and heart recovery to brain recovery, and increases the success rate of CPR, spontaneous circulation recovery and spontaneous breathing recovery in a part of patients. More trials of the high quality are required.