预防造影剂肾病水化时机选择的Meta分析

目的评价预防造影剂肾病(CIN)不同口服水化时机选择的效果,为降低CIN发生率提供依据。方法运用计算机检索PubMed、EMbase、The Cochrane Library、中国知网、万方数据库、维普数据库以及中国生物医学文献数据库关于口服水化预防造影剂肾病的随机对照试验(RCT),检索时间从建库至2020年9月。由2名研究人员独立筛选文献、提取基本资料并根据Cochrane手册评价文献的质量,采用RevMan 5.3软件进行Meta分析。结果共纳入11个CRT研究,1927例患者。Meta分析结果显示,术后6 h内定时定量饮水可降低CIN的发病率RR=0.33,95%CI(0.20,0.54),P<0.01],同时定时定量饮水可减少尿潴留的发生RR=0.48,95%CI(0.30,0.77),P=0.003]及胃部不适感RR=0.57,95%CI(0.38,0.85),P=0.006]。结论有计划定时定量饮水进行水化疗法可降低造影剂肾病的发生率,减少了尿潴留的发生及胃部不适感。

Meta analysis of the timing of hydration prevention in contrast induced nephropathy

Objective To systematically evaluate the effect of different timing of oral hydration in the prevention of contrast-enhanced nephropathy(CIN),so as to provide basis for reducing the incidence of CIN.Methods The randomized controlled trial(RCT)was searched by PubMed,EMBASE,the Cochrane Library,CNKI,Wanfang database,VIP database and Chinese biomedical literature database.The retrieval time was from the establishment to September 2020.Two researchers independently selected literature,extracted basic data and evaluated the quality of literature according to Cochrane manual,and used Revman 5.3 software for Meta analysis.Results A total of 1927 patients were enrolled in 12 CRT studies.Meta analysis showed that Quantitative 6 h drinking water can reduce the incidence rate of CIN after operationRR=0.33,95%CI(0.20,0.54),and P<0.01],while the regular quantitative drinking water could reduce the incidence of urinary retentionRR=0.48,95%CI(0.30,0.77),P=0.003],and stomach discomfortRR=0.57,95%CI(0.38,0.85),P=0.006].Conclusion current evidence shows that planned and regular drinking water treatment can reduce the incidence of contrast nephropathy and reduce the incidence of urinary retention and stomach discomfort.However,due to the limitations of the quantity and quality of the research included in the literature,the above conclusions still need to be verified by more high-quality research.