俯卧位通气治疗ARDS患者有效性与安全性的Meta分析

doi:10.3969/j.issn.1672-1756.2017.09.006

俯卧位通气治疗ARDS患者有效性与安全性的Meta分析

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

兰州大学第一医院重症医学科，730000 兰州市（岳伟岗，张志刚，杨丽平，张莹，蒋由飞，袁鹏，尹瑞元，冯鑫）；护理部（张彩云）；循证医学中心（田金徽）

出版日期:2017-09-25 发布日期:2017-09-25
基金资助:
甘肃省卫生行业科研计划项目（GSWSKY-2015-86）；实用新型专利（201620051950）

The efficacy and safety of prone positioning ventilation in treatment of Acute Respiratory Distress Syndrome: a Meta-analysis

Online:2017-09-25 Published:2017-09-25

摘要/Abstract

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PubMed、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RevMan 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。

Abstract: 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.

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. 俯卧位通气治疗ARDS患者有效性与安全性的Meta分析[J]. , 2017, 17(9): 1176-1181.