Dickinson K, Roberts I
Life Sciences, University College London, Gower Street, London, UK.
Cochrane Database Syst Rev. 2000;1999(2):CD001856. doi: 10.1002/14651858.CD001856.
Medical antishock trousers (MAST) have been used to increase venous return to the heart until definitive care could be given. This, combined with compression of blood vessels, is believed to cause the movement of blood from the lower body to the brain, heart and lungs. However, the equipment is expensive, and may have adverse effects.
To quantify the effect on mortality and morbidity of the use of medical anti-shock trousers (MAST)/ pneumatic anti-shock garments (PASG) in patients following trauma.
Trials were identified by searches of the Cochrane Injuries Group Trials Register, the Cochrane Controlled Trials Register, MEDLINE, EMBASE, BIDS ISI Service and Science Citation Index. References in relevant papers identified were followed up. A citation analysis of references to randomised controlled trials was conducted using the Science Citation Index. Authors of identified trials were contacted and asked about any other trials that may have been conducted, whether published or unpublished.
Randomised and quasi-randomised trials of MAST/PASG in patients following trauma (excluding fractures of the extremities in which MAST/PASG may be used as a splint).
Data were extracted independently by two reviewers. Data were collected on mortality, duration of hospitalisation and ICU stay, and quality of allocation concealment.
Two trials were identified that met the inclusion criteria. These trials included 1202 randomised patients in total; however, data for only 1075 of these were available. The relative risk of death with MAST was 1.13 (95% CI 0.97 to 1.32). Duration of hospitalisation and of intensive care unit stay was longer in the MAST treated group. The weighted mean difference in the length of intensive care unit stay was 1.7 days (95% CI 0.33 to 2.98).
REVIEWER'S CONCLUSIONS: There is no evidence to suggest that MAST/PASG application reduces mortality, length of hospitalisation or length of ICU stay in trauma patients and it is possible that it may increase these. These data do not support the continued use of MAST/PASG in the situation described. However, it should be recognised that, due to the poor quality of the trials, conclusions should be drawn with caution.
医用抗休克裤（MAST）一直被用于增加静脉回心血量，直至能给予确定性治疗。人们认为，这与血管受压相结合，会促使血液从下半身流向脑、心脏和肺部。然而，该设备价格昂贵，且可能有不良影响。
量化使用医用抗休克裤（MAST）/气动抗休克服（PASG）对创伤患者死亡率和发病率的影响。
通过检索Cochrane损伤组试验注册库、Cochrane对照试验注册库、MEDLINE、EMBASE、BIDS ISI服务和科学引文索引来识别试验。对相关论文中识别出的参考文献进行追踪。使用科学引文索引对随机对照试验的参考文献进行引文分析。与识别出的试验的作者取得联系，询问他们是否进行过其他试验，无论是否已发表。
MAST/PASG用于创伤患者（不包括四肢骨折，在四肢骨折中MAST/PASG可作为夹板使用）的随机和半随机试验。
由两名评价员独立提取数据。收集了死亡率、住院时间和重症监护病房停留时间以及分配隐藏质量的数据。
识别出两项符合纳入标准的试验。这些试验总共纳入了1202例随机分组的患者；然而，其中只有1075例患者的数据可用。使用MAST的死亡相对风险为1.13（95%CI 0.97至1.32）。MAST治疗组的住院时间和重症监护病房停留时间更长。重症监护病房停留时间的加权平均差为1.7天（95%CI 0.33至2.98）。
没有证据表明应用MAST/PASG可降低创伤患者的死亡率、住院时间或重症监护病房停留时间，而且有可能会增加这些指标。这些数据不支持在所述情况下继续使用MAST/PASG。然而，应该认识到，由于试验质量较差，得出结论时应谨慎。
