【摘要】：目的:本研究主要是系統(tǒng)評價俯臥位通氣與常規(guī)仰臥位通氣相比，能否改善急性肺損傷和急性呼吸窘迫綜合癥的病死率，以及不良事件發(fā)生率。 方法:廣泛收集俯臥位通氣用于治療成人急性肺損傷/急性呼吸窘迫綜合癥患者的臨床隨機(jī)對照試驗(yàn)，檢索數(shù)據(jù)庫Cochrane Library、PubMed、EMBASE、Web of Science和中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫,檢索方法采用MeSH主題詞檢索、自由詞檢索以及布爾邏輯運(yùn)算連接詞結(jié)合的方式,對納入文獻(xiàn)的參考文獻(xiàn)進(jìn)行二次檢索。對所得文獻(xiàn)依據(jù)納入與排除標(biāo)準(zhǔn)進(jìn)行審核，并評價文獻(xiàn)質(zhì)量。對納入文獻(xiàn)提取基線數(shù)據(jù)、病死率、不良事件發(fā)生率，并用RevMan5.2.6軟件進(jìn)行分析，病死率合并效應(yīng)值采用RD值，不良事件發(fā)生率采用OR值。 結(jié)果:入選5篇文獻(xiàn)，共1024位患者，病死率合并效應(yīng)值RD為-0.12，95%CI[-0.18,-0.06],Z=4.12(P 0.0001)。氣胸發(fā)生率效應(yīng)值OR為1.12,95%CI[0.59,2.11],Z=0.34(P=0.73),氣管導(dǎo)管意外發(fā)生率效應(yīng)值OR為1.61，95%CI為[1.03,2.49],Z=2.11(P=0.03)。 結(jié)論:與常規(guī)仰臥位通氣相比，，俯臥位通氣聯(lián)合小潮氣量（VT≤10ml/kg）、限制平臺壓（吸氣末峰壓或平臺壓≤35cmH2O）的肺保護(hù)性通氣策略治療早期ALI/ARDS成人患者，可以降低總體病死率，但氣管導(dǎo)管意外發(fā)生率增加。
[Abstract]:Objective: to evaluate systematically whether prone position ventilation can improve the mortality and incidence of adverse events in acute lung injury and acute respiratory distress syndrome compared with conventional supine position ventilation. Methods: a randomized controlled trial of prone position ventilation for adult patients with acute lung injury / acute respiratory distress syndrome (ARDS) was widely collected. The database Cochrane Library,PubMed,EMBASE,Web of Science and the Chinese biomedical literature database were searched. The retrieval method uses MeSH subject word retrieval, free word retrieval and Boolean logic operation conjunction to research the references that are included in the literature. Review and evaluate the quality of the literature according to the inclusion and exclusion criteria. The baseline data, mortality and incidence of adverse events were collected from the literature. The combined effect value of case fatality rate and the incidence rate of adverse events were analyzed by RevMan5.2.6 software. The combined effect value of case fatality rate was RD value, and the incidence rate of adverse events was OR value. Results: 1024 patients were included in 5 articles. The mortality combined effect value (RD) was -0.12 鹵95 (CI = -0.18 鹵0.06), Zu 4.12 (P 0.0001). The incidence effect of pneumothorax was 1.1295 CI [0.59 鹵2.11], Z = 0.34 (P < 0.73), OR = 1.61V / 95 CI = 1.03 鹵2.49, Z = 2.11 (P = 0.03). Conclusion: compared with conventional supine position ventilation, prone position ventilation combined with low tidal volume (VT 鈮

本文編號：2380494