發(fā)布時間：2018-08-18 19:06

【摘要】：目的系統(tǒng)評價俯臥位通氣在新生兒呼吸窘迫綜合征中的應用效果。方法計算機檢索Pub Med、EMBASE、Cochrane Library、Web of Science、中國生物醫(yī)學文獻數(shù)據(jù)庫、中國學術期刊全文數(shù)據(jù)庫、萬方和維普等國內外數(shù)據(jù)庫中有關俯臥位通氣應用于新生兒呼吸窘迫綜合征的隨機對照試驗和隨機交叉試驗。對所得文獻依據(jù)納入與排除標準進行篩查,提取資料,評價文獻質量,采用Rev Man 5.3軟件進行Meta分析。結果最終共納入10項研究,7項隨機對照試驗和3項隨機交叉試驗,包括500例研究對象。Meta分析結果顯示,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]、顱內出血發(fā)生率[RR=0.41,95%CI(0.20,0.83),P=0.01]和機械通氣時間[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)計學意義;呼吸機相關性肺炎發(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)計學意義。結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,縮短機械通氣時間,降低氣胸和顱內出血的發(fā)生風險,而對降低呼吸機相關性肺炎的發(fā)生率則無明顯作用。由于本研究評價指標間存在異質性,且各評價指標納入的符合標準的研究也不足。因此,需要更多臨床多中心、大樣本、高質量的研究進一步評價俯臥位通氣應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：2190395