摘要目的 评价围手术期应用极化液治疗对冠状动脉搭桥术患者早期预后的影响.方法 计算机检索Cochrane图书馆(2011年第3期)、PubMed、EMBase、MEDLINE、Highwire、CBM、CNKI等中外生物医学数据库,收集关于行冠状动脉搭桥术患者围手术期应用极化液治疗的随机对照试验,检索日期由2000年1月至2011年12月.按Cochrane系统评价方法,评价所纳入研究的文献质量,并提取有效数据后采用RevMan5.0软件进行meta分析.结果 纳入9项研究,共计1029例患者.Meta分析显示:围手术期应用极化液治疗可降低患者术后心肌梗死发生率(RR=0.59,95％ CI:0.38～0 91,P =0.02),显著降低正性肌力药物使用率(RR =0.44,95％ CI:0.35 ～0.56,P＜0.01),亦可增加术后心房颤动发生率(RR=1.23,95％ CI:1.05～1.43,P =0.009),但对重症监护病房滞留时间(WMD=-1.47,95％ CI:-5 91 ～2.96.P=0.51)没有影响.结论 围手术期应用极化液治疗可减少行冠状动脉搭桥术患者早期心肌损伤并改善心功能,但可增加术后房颤发生率.

abstractsObjective To assess the effect of perioperative glucose-insulin-potassium (GIK)infusions on the prognosis in patients undergoing coronary artery bypass grafting.Methods Electronic databases including Cochrane library (Issue 3,2011),Pubmed,EMbase,Highwire,CBM and CNKI were searched.A meta-analysis of all randomized controlled trials (RCTs) comparing GIK with control in coronary artery bypass grafting was performed.Study selection and meta-analysis were conducted which according to the Cochrane Handbook for systematic reviews.Date were extracted from these trials by 3 reviewers independently and analyzed by RevMan5.0 software.Results A total of 9 RCTs including 1029 patients were assessed in this study.GIK infusion was associated with significantly fewer perioperative myocardial infarctions (RR =0.59,95％ CI: 0.38-0.91,P =0.02),less inotropic support requirement (RR =0.44,95 ％ CI:0.35-0.56,P ＜ 0.01),and increase the incidence of postoperative atrial fibrillation (RR=1.23,95％ CI:1.05-1.43,P=0.009).Conclusions GIK significantly reduces myocardial injury and improves cardiac function in patients undergoing coronary artery bypass grafting,but also increases the incidence of postoperative atrial fibrillation.