头罩和面罩无创通气对急性呼吸衰竭患者疗效的荟萃分析

发布时间：2018-02-16 09:18

本文关键词： 头罩面罩无创通气疗效　出处：《中国呼吸与危重监护杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的采用荟萃分析方法研究在急性呼吸衰竭(ARF)患者中使用头罩和面罩无创通气的疗效。方法以"helmet,face mask,facial mask"和"mechanical ventilation或noninvasive ventilation"为英文检索词,检索Pub Med、OVID、Embase、Scopus和Cochrane等数据库,并搜索相关网页及参考文献。以"头罩、面罩、机械通气、无创通气"为中文检索词,检索中国知网和万方数据库。检索时间为建库至2016年12月。2名研究人员分别独立评估试验质量和提取信息。采用Revman 5.3对数据进行合并统计分析。结果最终纳入10项随机对照试验(RCTs)和6项病例对照试验。荟萃分析结果显示,与面罩相比,头罩无创通气降低气管插管率(OR=0.35,95%CI为0.24~0.51,P0.000 01)、住院死亡率(OR=0.51,95%CI为0.34~0.76,P=0.001)、无创通气相关并发症(OR=0.10,95%CI为0.06~0.15,P0.000 01)。在改善气体交换方面两组间没有显著差异。在亚组分析中,ARF的类型和通气模式不影响插管率和无创通气相关并发症,头罩无创通气主要降低低氧血症性ARF或压力支持通气患者的住院死亡率。结论头罩无创通气可以降低ARF患者的插管率、住院死亡率和无创通气相关并发症。头罩在改善患者气体交换方面与面罩同样有效。然而,未来仍需要更多的随机对照试验来进一步确定头罩无创通气的作用。
[Abstract]:Objective to study the method of meta analysis in acute respiratory failure (ARF) patients using the hood and mask effect of noninvasive ventilation. The method of "helmet, face mask, facial mask and mechanical ventilation or noninvasive ventilation English" as search words, search Pub Med, OVID, Embase, Scopus and Cochrane databases. And search for relevant web pages and the references. "Hood, mask, mechanical ventilation, ventilation" as the key words Chinese, China retrieval of CNKI and Wanfang database. The retrieval time is respectively up to December 2016.2 the researchers assessed trial quality and extracted information. Using Revman 5.3 for data with statistical analysis. Results we included 10 randomized controlled trials (RCTs) and 6 case-control study. The meta-analysis showed that compared with the mask, hood ventilation to reduce endotracheal intubation (OR=0.35,95%CI, 0.24~0.51, P0 .000 01 (OR=0.51,95%CI), hospital mortality was 0.34~0.76, P=0.001), noninvasive ventilation related complications (OR=0.10,95%CI 0.06~0.15, P0.000 01). To improve gas exchange between the two groups had no significant difference. In the subgroup analysis, the type of ARF and the ventilation mode does not affect the invasive ventilation and no complications related to intubation rate, head the cover of noninvasive ventilation mainly reduce hypoxemia of ARF or pressure support ventilation in patients with hospital mortality. Conclusion the head cover of noninvasive ventilation can reduce intubation in patients with ARF rate, hospital mortality and noninvasive ventilation related complications. The hood was equally effective in improving patients with gas exchange and mask. However, the future still need a randomized controlled trial more to further determine the role of noninvasive ventilation hood.

【作者单位】：四川大学华西医院呼吸与危重症医学科;四川大学华西医院急诊科;
【分类号】：R563.8

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