LISA技術(shù)治療新生兒呼吸窘迫綜合征有效性的系統(tǒng)評(píng)價(jià)
發(fā)布時(shí)間：2018-08-24 09:08
【摘要】：目的評(píng)價(jià)經(jīng)微管氣管內(nèi)注入肺泡表面活性劑(LISA)聯(lián)合持續(xù)氣道正壓通氣(CPAP)序貫技術(shù)治療新生兒呼吸窘迫綜合征(RDS)的有效性。方法檢索PubMed、EMBASE、Cochrane圖書(shū)館、相關(guān)期刊論文、萬(wàn)方數(shù)據(jù)庫(kù)、維普中文科技期刊數(shù)據(jù)庫(kù)及中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù),查找所有LISA聯(lián)合CPAP治療RDS的隨機(jī)對(duì)照試驗(yàn)。采用RevMan 5.2軟件進(jìn)行meta分析,分別比較胎齡34周罹患RDS的早產(chǎn)兒中,LISA組和對(duì)照組的病死率以及支氣管肺發(fā)育不良(BPD)、早產(chǎn)兒視網(wǎng)膜病(ROP)、腦室內(nèi)出血(IVH)、腦室周圍白質(zhì)軟化(PVL)等并發(fā)癥發(fā)生率的差異。結(jié)果共納入5篇隨機(jī)對(duì)照研究,含759例患兒。與對(duì)照組相比,LISA組患兒機(jī)械通氣比率低(RR:0.32,95%CI:0.13~0.82);BPD發(fā)生率低(RR:0.61,95%CI:0.42~0.88);但兩組患兒病死率、ROP、IVH、氣胸及PVL發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論 LISA技術(shù)治療新生兒呼吸窘迫綜合征可明顯降低機(jī)械通氣及BPD發(fā)生率,但對(duì)其他并發(fā)癥發(fā)生率及病死率無(wú)影響。
[Abstract]:Objective to evaluate the efficacy of intratracheal instillation of alveolar surfactant (LISA) with continuous positive airway pressure (CPAP) in the treatment of neonatal respiratory distress syndrome (RDS). Methods PubMed,EMBASE,Cochrane library, full text database of Chinese periodicals, Wanfang database, Weipu Chinese science and technology journal database and Chinese biomedical literature database were searched for all randomized controlled trials of LISA combined with CPAP therapy for RDS. Meta analysis was carried out with RevMan 5.2 software. The mortality of premature infants with RDS at 34 weeks of gestational age and the incidence of complications such as (ROP), intraventricular hemorrhage in (BPD), premature infants with bronchopulmonary dysplasia and (PVL) in periventricular leukomalacia were compared. Results A total of 5 randomized controlled studies were conducted, including 759 children. Compared with the control group, the incidence of mechanical ventilation (RR:0.32,95%CI:0.13~0.82) and bpd (RR:0.61,95%CI:0.42~0.88) was lower, but there was no significant difference in mortality, pneumothorax and PVL between the two groups (P < 0. 05). Conclusion LISA can significantly reduce the incidence of mechanical ventilation and BPD, but has no effect on other complications and mortality.
【作者單位】： 深圳市寶安區(qū)婦幼保健院新生兒科;臺(tái)灣中國(guó)醫(yī)藥大學(xué)兒科學(xué)院新生兒科;
【分類號(hào)】：R722.1
本文編號(hào)：2200315
[Abstract]:Objective to evaluate the efficacy of intratracheal instillation of alveolar surfactant (LISA) with continuous positive airway pressure (CPAP) in the treatment of neonatal respiratory distress syndrome (RDS). Methods PubMed,EMBASE,Cochrane library, full text database of Chinese periodicals, Wanfang database, Weipu Chinese science and technology journal database and Chinese biomedical literature database were searched for all randomized controlled trials of LISA combined with CPAP therapy for RDS. Meta analysis was carried out with RevMan 5.2 software. The mortality of premature infants with RDS at 34 weeks of gestational age and the incidence of complications such as (ROP), intraventricular hemorrhage in (BPD), premature infants with bronchopulmonary dysplasia and (PVL) in periventricular leukomalacia were compared. Results A total of 5 randomized controlled studies were conducted, including 759 children. Compared with the control group, the incidence of mechanical ventilation (RR:0.32,95%CI:0.13~0.82) and bpd (RR:0.61,95%CI:0.42~0.88) was lower, but there was no significant difference in mortality, pneumothorax and PVL between the two groups (P < 0. 05). Conclusion LISA can significantly reduce the incidence of mechanical ventilation and BPD, but has no effect on other complications and mortality.
【作者單位】： 深圳市寶安區(qū)婦幼保健院新生兒科;臺(tái)灣中國(guó)醫(yī)藥大學(xué)兒科學(xué)院新生兒科;
【分類號(hào)】：R722.1
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