【摘要】：目的系統(tǒng)評(píng)價(jià)俯臥位通氣在新生兒呼吸窘迫綜合征中的應(yīng)用效果。方法計(jì)算機(jī)檢索Pub Med、EMBASE、Cochrane Library、Web of Science、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫、萬方和維普等國內(nèi)外數(shù)據(jù)庫中有關(guān)俯臥位通氣應(yīng)用于新生兒呼吸窘迫綜合征的隨機(jī)對(duì)照試驗(yàn)和隨機(jī)交叉試驗(yàn)。對(duì)所得文獻(xiàn)依據(jù)納入與排除標(biāo)準(zhǔn)進(jìn)行篩查,提取資料,評(píng)價(jià)文獻(xiàn)質(zhì)量,采用Rev Man 5.3軟件進(jìn)行Meta分析。結(jié)果最終共納入10項(xiàng)研究,7項(xiàng)隨機(jī)對(duì)照試驗(yàn)和3項(xiàng)隨機(jī)交叉試驗(yàn),包括500例研究對(duì)象。Meta分析結(jié)果顯示,俯臥位通氣組的SaO_2[MD=2.41,95%CI(0.87,3.95),P=0.002]、PaO_2[MD=5.20,95%CI(3.04,7.36),P0.001]、PaO_2/FiO_2[MD=24.40,95%CI(8.35,40.44),P=0.003]、氣胸發(fā)生率[RR=0.10,95%CI(0.01,0.76),P=0.03]、顱內(nèi)出血發(fā)生率[RR=0.41,95%CI(0.20,0.83),P=0.01]和機(jī)械通氣時(shí)間[MD=-23.22,95%CI(-38.30,-8.14),P=0.003]與仰臥位通氣組相比,差異具有統(tǒng)計(jì)學(xué)意義;呼吸機(jī)相關(guān)性肺炎發(fā)生率[RR=0.72,95%CI(0.48,1.09),P=0.12]與仰臥位通氣組相比,差異無統(tǒng)計(jì)學(xué)意義。結(jié)論俯臥位通氣能夠有效改善呼吸窘迫綜合征新生兒的SaO_2、PaO_2和PaO_2/FiO_2,縮短機(jī)械通氣時(shí)間,降低氣胸和顱內(nèi)出血的發(fā)生風(fēng)險(xiǎn),而對(duì)降低呼吸機(jī)相關(guān)性肺炎的發(fā)生率則無明顯作用。由于本研究評(píng)價(jià)指標(biāo)間存在異質(zhì)性,且各評(píng)價(jià)指標(biāo)納入的符合標(biāo)準(zhǔn)的研究也不足。因此,需要更多臨床多中心、大樣本、高質(zhì)量的研究進(jìn)一步評(píng)價(jià)俯臥位通氣應(yīng)用于新生兒呼吸窘迫綜合征的效果。
[Abstract]:Objective to evaluate the effect of prone position ventilation in neonatal respiratory distress syndrome. Methods A computer search was conducted for Pub Medmella Cochrane Library Web of Science, Chinese Biomedical Literature Database and full text Database of Chinese academic Journals. The application of prone position ventilation in the databases of Wanfang and Wiper in neonatal respiratory distress syndrome is a randomized controlled trial and a random cross trial. According to the inclusion and exclusion criteria, the literature was screened, the data was extracted, the quality of the literature was evaluated, and the Meta analysis was carried out with Rev Man 5.3 software. Results A total of 10 randomized controlled trials and 3 randomized crossover trials were included, including 500 subjects. Meta-analysis showed that, 淇崸浣嶉，

本文編號(hào)：2190395