成年病人零负压与非零负压气管内吸痰效果的Meta分析  

Meta analysis of effect of zero negative pressure and non zero negative pressure endotracheal suctioning in adult patients

作　　者：李莉莉[1] 姚惠萍[2] 张丽君[1] 常阳阳[1] 史平[1] 

机构地区：[1]湖州师范学院护理学院 [2]浙江省人民医院

出　　处：《护理研究（上旬版）》2015年第3期823-828,共6页Chinese Nursing Researsh

摘　　要：[目的]分析成年病人传统吸痰法(将吸痰管无负压下直接插入气管深处,再打开负压边吸边旋转退出)即零负压进入气管内吸痰法与非零负压进入气管内吸痰方法(非零负压吸痰法)的效果。[方法]以计算机全面收集国内关于吸痰方法用于气管插管和气管切开病人的随机对照试验(RCT)文章,按澳大利亚JBI循证卫生保健中心的系统评价方法筛选文献、评价纳入文献质量,使用RevMan 5.0软件进行统计分析。[结果]共纳入8篇文献,其中2篇质量评价为B级,6篇质量评价为C级;纳入446例研究对象,其中试验组221例,对照组225例;Meta分析结果:非零负压吸痰法与传统吸痰法相比,可以减少对气道黏膜的损伤(RR=0.31,95%CI为0.21~0.46,P<0.000 01),降低肺部感染(RR=0.36,95%CI为0.24~0.52,P<0.000 01),减少24h内吸痰次数(WMD=-6.58,95%CI为-10.03^-3.12,P=0.000 2),减少24h内吸痰总量(WMD=-34.34,95%CI为-60.73^-7.95,P=0.01)。[结论]对成年病人采用非零负压吸痰法时呼吸道黏膜损伤、肺部感染、24h内吸痰次数及吸痰总量的效果优于传统吸痰法。Objective：To analyze the effect of the traditional sputum suction method（the sputum suction tube in-serting into the deep trachea directly without negative pressure,and then as suctioning as spining exited by openning the negative pressure）which is the endotracheal suction method of inserting into the trachea under zero negative pressure and non zero negative pressure（non zero negative pressure endotracheal suctioning）in adult patients.Methods：Comprehensively collected the randomized controlled trial（RCT）articles about the endotra-cheal suction method using for tracheal intubation and tracheotomy patients by computer,screened literatures and evaluated their quality by system evaluation method of Australia’s JBI center of evidence based health care, and made statistical analysis by using RevMan 5.0.Results：A total of 8 literatures were included.2 quality eval-uation were the B level.Others were the class C.A total of 446 cases of study objects were included.While 221 cases in experimental team and 225 cases in control team.The result of Meta analysis was that comparing with the traditional sputum suction method,the non negative pressure endotracheal suction method could reduce air-way mucosa injury （RR=0.31,95%CI =0.21~0.46,P 〈0.000 01）,pulmonary infection （RR=0.36,95%CI =0.24~0.52,P 〈0.000 01）,suction phlegm times within 24 h（WMD=-6.58,95%CI =-10.03^-3.12,P =0.000 2）,and the suction phlegm amount with 24 h（WMD=-34.34,95%CI =-60.73 ^-7.95,P =0.01 ）. Conclusion：The effect of reducing the airway mucosa injury,pulmonary infection,suction phlegm times within 24 h and suction phlegm amount with 24 h of the non negative pressure endotracheal suction method was better than that of the traditional sputum suction method.

关 键 词：负压 气管切开 人工气道 气管插管 吸痰 Meta 分析 

分 类 号：R472[医药卫生—护理学]