（优质课件）循证医学实践-案例分析.pptVIP

建议：文献检索从SR开始(2) 多个RCT的SR比单个RCT能提供更好的证据 三级资料库 二级资料库 原始资料库 * Cochrane Library Steroids for treating tuberculous pleurisy 3RCT, n=236 There was no difference in residual lung function between steroid and control groups number with pleural fluid, number with pleural thickening and number with pleural adhesions conclusions: There is insufficient evidence to know whether steroids are effective in tuberculous pleural effusion. * 结 果 激素治疗的有效性和应用价值值得商讨。研究显示在随访阶段，激素对改善症状和增加体重无作用；对减少胸水的残留和胸膜增厚、粘连，对改善肺功能的作用不明显或无作用。 充分的胸水引流可消除胸