气管切开时机对创伤患者预后的影响：一项荟萃分析。
The influence of tracheostomy timing on outcomes in trauma patients: A meta-analysis.
作者信息
Cai Shi-Qi, Hu Jun-Wu, Liu Dong, Bai Xiang-Jun, Xie Jie, Chen Jia-Jun, Yang Fan, Liu Tao
机构信息
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
出版信息
Injury. 2017 Apr;48(4):866-873. doi: 10.1016/j.injury.2017.02.023. Epub 2017 Feb 24.
OBJECTIVE
This study aims to assess the influence of tracheostomy timing on outcomes among trauma patients, including mortality, medical resource utility and incidence of pneumonia.
METHOD
A systematic review of the literature was conducted by internet search. Data were extracted from selected studies and analyzed using Stata to compare outcomes in trauma patients with early tracheostomy (ET) or late tracheostomy (LT)/prolonged intubation (PI).
RESULT
20 studies met our inclusion criteria with 3305 patients in ET group and 4446 patients in LT/PI group. Pooled data revealed that mortality was not lower in trauma patients with ET compared to those with LT/IP. However, ET was found to be associated with a significantly reduced length of ICU and hospital stay, shorter MV duration and lower risk of pneumonia.
CONCLUSION
Evidence of this meta-analysis supports the dimorphism in some clinical outcomes of trauma patients with different tracheostomy timing. Additional well-designed randomized controlled trials (RCTs) are needed to confirm it in future.
目的
本研究旨在评估气管切开时机对创伤患者结局的影响，包括死亡率、医疗资源利用情况及肺炎发生率。
方法
通过互联网搜索对文献进行系统回顾。从选定的研究中提取数据，并使用Stata进行分析，以比较早期气管切开（ET）或晚期气管切开（LT）/延长插管（PI）的创伤患者的结局。
结果
20项研究符合我们的纳入标准，ET组有3305例患者，LT/PI组有4446例患者。汇总数据显示，与LT/IP患者相比，ET创伤患者的死亡率并未降低。然而，发现ET与ICU住院时间和住院时间显著缩短、机械通气时间缩短及肺炎风险降低相关。
结论
该荟萃分析的证据支持不同气管切开时机的创伤患者在某些临床结局上存在二态性。未来需要更多设计良好的随机对照试验（RCT）来证实这一点。
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