作 者: (岳伟岗); (张彩云); (张志刚); (杨丽平); (张莹); (蒋由飞); (袁鹏); (尹瑞元); (冯鑫); (田金徽);
机构地区: 兰州大学第一医院重症医学科,兰州市730000
出 处: 《中国护理管理》 2017年第9期1176-1181,共6页
摘 要: 目的 :评价俯卧位通气治疗急性呼吸窘迫综合征患者的有效性及安全性。方法 :计算机检索Pub Med、Embase、Web of Sience、the Cochrane Library、中国知网、中国生物医学文献、维普、万方数据库中发表的关于俯卧位通气对ARDS患者影响的相关研究,纳入文献的质量由两名经过专业循证医学培训的学生完成,采用Rev Man 5.3软件对纳入文献进行Meta分析。结果 :共纳入9篇随机对照试验文献,纳入患者数2 359人。Meta分析结果显示,病死率效应值[OR=0.60,95%CI(0.40,0.90),P=0.01],合并效应有统计学意义;而在意外脱管发生率、呼吸机相关性肺炎发生率、气胸发生率、ICU住院时间方面并无统计学意义。结论 :俯卧位通气可降低ARDS患者病死率,且不增加意外脱管率,但在预防呼吸机相关性肺炎(VAP)、气胸发生率及ICU住院时间方面并无统计学意义。 Objective: To evaluate the efficacy and safety of prone position ventilation for patients with Acute Respiratory Distress Syndrome (ARDS). Methods: The studies published in PubMed, Embase, Web of Science, the Cochrane Library, CBM, CNKI, VIP, Wanfang database were analyzed. The meta-analysis was applied using RevMan 5.3 software. Results: A total of 9 randomized controlled studies and 2 359 subjects included were analyzed. Meta-analysis showed the mortality rate was statistically significant [OR=0.60, 95% CI (0.40, 0.90), P=0.01], and the combined effect was statistically significant. The incidence of accidental exhalation, ventilator-associated pneumonia, the incidence of pneumothorax, ICU hospitalization time were not statistically significant. Conclusion: The prone position ventilation can reduce the mortality rate of patients with ARDS.