高频振荡通气与常频通气治疗小儿急性呼吸窘迫综合征疗效的Meta分析

发布时间：2018-06-24 10:10

本文选题：高频振荡通气 + 常频机械通气　；参考：《中国当代儿科杂志》2017年04期

【摘要】：目的系统评价高频震荡通气(HFOV)与常频机械通气(CMV)治疗小儿急性呼吸窘迫综合征(ARDS)的疗效。方法计算机检索The Cochrane Library、PubMed、Medline、中国知网(CNKI)、万方(Wanfang Data)等数据库,收集关于HFOV与CMV比较治疗儿童ARDS的随机对照试验,检索时限从建库至2016年7月。由两位评价员按照纳入与排除标准独立筛选文献、提取资料并对文献质量进行评价,然后采用RevMan 5.3软件将纳入的研究进行Meta分析。结果最终纳入6项试验,共246例患儿。Meta分析结果显示:HFOV和CMV两种通气方式治疗在院内病死率或30 d病死率、气压伤发生率、平均通气时间和氧合指数方面差异均无统计学意义(P0.05);但相较CMV,HFOV提高了PaO_2/FiO_2比值(治疗后24 h、48 h、72 h分别提高了17%、24%、31%),改善了患儿氧合。结论与CMV相比,HFOV并没有降低ARDS患儿的病死率,但可显著改善氧合状态。最终结论尚需更多大样本、多中心、随机的临床对照研究进一步验证。
[Abstract]:Objective to evaluate the efficacy of high frequency oscillatory ventilation (HFOV) and normal frequency mechanical ventilation (CMV) in children with acute respiratory distress syndrome (ARDS). Methods the database of the Cochrane Library PubMedline, CNKI and Wanfang data were searched, and the randomized controlled trials of comparing HFOV and CMV for children with ARDS were collected. The searching time was from the construction of the database to July 2016. According to the criteria of inclusion and exclusion, the two evaluators independently sifted the literature, extracted the data and evaluated the quality of the literature, and then used Revman 5.3 software to conduct meta-analysis of the included research. Results A total of 246 children were included in 6 trials. The results of Meta-analysis showed that there were two kinds of ventilation methods: 1: HFOV and CMV in hospital or 30 days, and the incidence of barotrauma. There was no significant difference in mean ventilation time and oxygenation index (P0.05), but compared with CMV HFOV, the ratio of Pao / FiO / FiO2 was increased by 2 / FiO2 (24 h / 48 h / 72 h after treatment, respectively), and the oxygenation rate was improved by 17% (P < 0.05). Conclusion compared with CMV, HFOV does not decrease the mortality of children with ARDS, but can significantly improve the oxygenation state. The final conclusions need to be further validated by large, multicenter, randomized, controlled clinical trials.
【作者单位】：郑州大学第三附属医院儿科;浙江中医药大学;
【分类号】：R725.6

【相似文献】