抗生素吸入和静脉注射联合应用治疗呼吸机相关性肺炎的效果评价

发布时间：2018-05-13 00:29

本文选题：抗生素 + 吸入　；参考：《中国呼吸与危重监护杂志》2017年03期

【摘要】：目的评价抗生素吸入联合静脉注射对治疗呼吸机相关性肺炎(VAP)的应用效果。方法计算机检索Cochrane library、Joanna Briggs Institute Library、Pub Med、MEDLINE、CINAHL、CBM、CNKI及万方医学网中关于抗生素吸入联合静脉注射治疗VAP的文献。由3名研究者对文献质量进行严格评价和资料提取,对符合质量标准的进行Meta分析。结果共纳入13项研究。结果显示试验组VAP患者治愈率高于对照组,差异有统计学意义(RR=1.16,95%CI 1.07~1.56,P=0.000 5);两组死亡率(RR=1.04,95%CI 0.82~1.32,P=0.74)和肾功能损害发生率(RR=0.79,95%CI 0.51~1.22,P=0.29)差异均无统计学意义。致病菌清除方面差异有统计学意义(RR=1.38,95%CI 1.09~1.74,P=0.007),试验组患者呼吸道分泌物培养致病菌转阴率更高。结论抗生素吸入联合静脉注射可以提高VAP患者的治愈率,有效地清除致病菌,建议临床推广使用。
[Abstract]:Objective to evaluate the efficacy of antibiotic inhalation combined with intravenous injection in the treatment of ventilator-associated pneumonia (VAP). Methods the literatures of Cochrane libraryus Joanna Briggs Institute Library Pub Medus MEDLINE CINAHL CBMN CNKI and Wanfang Medical Network on antibiotic inhalation combined with intravenous injection were searched. The quality of literature was evaluated and extracted by three researchers, and Meta analysis was carried out to meet the quality standard. Results A total of 13 studies were included. The results showed that the cure rate of VAP patients in the trial group was higher than that in the control group, and the difference was statistically significant. There was no significant difference between the two groups in the mortality rate of RRN 1.0495 CI 0.82Cl 1.32P 0.74) and the incidence of renal function impairment (RR0.7995CI 0.51-1.22P0.29). There was a significant difference in the clearance of pathogenic bacteria between RRX 1.38 and 95% CI 1.09 and 1.74-Pu 0.007, and the negative rate of pathogenic bacteria in respiratory secretion culture of the test group was higher than that of the control group. Conclusion antibiotic inhalation combined with intravenous injection can improve the cure rate of VAP patients and effectively remove pathogenic bacteria.
【作者单位】：芜湖市第一人民医院呼吸内科;
【分类号】：R563.1

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