吸入一氧化氮治疗成人及儿童急性呼吸窘迫综合征并发症meta分析

发布时间：2018-02-01 11:56

本文关键词： 一氧化氮呼吸窘迫综合征成人急性呼吸窘迫综合征并发症　出处：《现代医药卫生》2016年19期 　论文类型：期刊论文

【摘要】：目的对吸入一氧化氮(iNO)治疗成人及儿童急性呼吸窘迫综合征(ARDS)并发症进行meta分析,以期为临床应用提供参考依据。方法应用计算机检索1990~2014年Cochrane Library、Pub Med、EMB Guideline、MD Consult、EBSCO、Science数据库,收录已公开发表的有关iNO治疗ARDS的中、英文文献,以肾功能损伤、颅内出血或脑白质软化(PVL)、视网膜病变、颅神经损伤等发生率作为终点疗效观察指标,得出合并后疗效的优势比(OR)及其95%可信区间(95%CI),然后进行定性、定量综合评估,按纳入、排除标准对合格文献进行质量评价。结果 (1)iNO治疗组患者中发生肾功能损伤例数(93例)高于对照组(53例),差异有统计学意义(P0.05);发生PVL例数(26例)与对照组(39例)比较,差异无统计学意义(P0.05);颅神经损伤例数(6例)低于对照组(9例),但差异无统计学意义(P0.05);(2)神经损伤:视网膜病变例数(9例)低于对照组(13例),但差异无统计学意义(P0.05)。结论 iNO治疗ARDS会增加成人肾功能损伤的风险,因此不推荐使用iNO治疗有肾功能损伤的ARDS成人患者。
[Abstract]:Objective to analyze the complications of acute respiratory distress syndrome (ARDS) treated with inhaled nitric oxide (no) in adults and children by meta. Methods Cochrane Library Pub Med was searched by computer from 1990 to 2014. EMB Guideline MD consult EBSCON Science database, including published Chinese and English literature on iNO treatment of ARDS. The incidence of renal function injury, intracranial hemorrhage or leukomalacia PVL, retinopathy and cranial nerve injury were used as the end point. The results showed that the advantage of the combined effect was higher than that of OR) and its 95% confidence interval of 95% CIQ, then qualitative and quantitative comprehensive evaluation was carried out, according to the inclusion. Results 93 cases of renal function injury in the treatment group were higher than that in the control group (53 cases). The difference was statistically significant (P 0.05). There was no significant difference between PVL (n = 26) and control group (n = 39). The number of cranial nerve injuries in 6 cases was lower than that in the control group (9 cases), but the difference was not statistically significant (P 0.05). (2) nerve injury: the number of retinopathy (9 cases) was lower than that in the control group (13 cases). Conclusion iNO can increase the risk of renal function injury in adult patients with ARDS. Therefore, iNO is not recommended for the treatment of adult ARDS patients with renal function impairment.
【作者单位】：重庆医科大学附属第二医院呼吸内科;
【基金】：国家青年自然科学基金资助项目(81200028)
【分类号】：R563.8;R725.6
【正文快照】： 急性呼吸窘迫综合征(acute respiratory distress syn-drome,ARDS)是严重感染、休克、创伤及烧伤等非心源性疾病过程中并发的一种临床常见危重症,病死率高达30%[1],目前已成为重症监护病房(ICU)患者死亡的主要原因之一,且吸入一氧化氮(i NO)能改善患者的氧合状况[1]。1987年,P

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