机械通气患者留置鼻空肠管预防呼吸机相关性肺炎疗效的系统评价  

作　　者：刘玉梅[1] 王登[1] 范道圣 

机构地区：[1]湖北省鄂州市中心医院呼吸内科,湖北鄂州436000

出　　处：《中国药业》2015年第B12期171-174,共4页China Pharmaceuticals

摘　　要：目的探讨机械通气患者留置鼻空肠管对于预防呼吸机相关性肺炎的疗效。方法通过检索自1995年1月至2015年1月万方数据库、维普中文科技期刊数据库、中国学术期刊数据库、美国国立医学图书馆、科克兰图书馆、西文生物医学期刊数据库、医学文摘数据库、学术期刊集成数据库等数据库内相关的随机对照试验（RCT），对纳入文献的质量进行严格评价和资料提取，使用Stata／SEversion12．0软件对纳入研究进行系统评价。结果最终纳入5篇RCT，共243例患者，其中实验组患者122例、对照组患者121例。所有患者均于肠蠕动恢复后置管，对照组患者留置鼻胃管、实验组患者留置鼻空肠管。Meta分析显示，相比留置胃管，留置空肠管能显著降低患者的机械通气时间[P=0．040，／2=60．0％，SMD-1．18，95％CI=（-1．62，-0．74）]，其发表偏倚可控，结果稳健[biasp=0．507，bias_95CI=（-20.84839,12.88272）]；相比留置胃管，留置空肠管能显著降低患者的VAP发病率[P=0．786，／2=0％，RR=0．44，95％CI=（0．25，0．78）]，其发表偏倚可控，结果稳健[bias_p=0．735，bias-95CI=（-4．904799，3．878029）]。结论相比于鼻胃管，机械通气患者留置鼻空肠管，可显著缩短其机械通气时间，降低呼吸机相关性肺炎的发生率，其疗效确切，值得临床推广。Objective To evaluate the effect of the mechanical ventilation in patients with indwelling nasogastric tube prevention of ventilator-associated pneumonia. Methods By searching the RCT PubMed, BMA, EMbase, ASP, The Coehrane Library, EMCC, CBM, CNKI, CECDB, CQVIP, VIP database in 1994 January to 2014 November period, strict appraisal and data extraction on the quality of the included studies, using Stata/SE version 12 software systematic evaluation of included studies. Results Eventually included five RCT, a total of 243 cases of patients, including 122 cases of patients in the experimental group, 121 patients in the control group. All patients were in the recovery of bowel movement catheterization, indwelling nasogastrie patients in the control group, the experimental group of patients with indwelling nasogastric tube. Meta-analysis showed that, compared indwelling tube, indwelling jejunal tube can significantly reduce the duration of mechanical ventilation in patients with [P=0.040, P=60.0%, SMD=-1.18,95% CI=（-1.62, -0.74）], which publication bias control, the results sound [bias p=0.507, bias_95 CI=（-20.848 39, 12.882 72）1; compared with indwelling tube, indwelling jejunal tube can significantly reduce the incidence of VAP patients [P=0.786, /2=0%, RR=0.44,95% CI=（0.25, 0.78）1, whose publication bias control, the results sound [bias_p=0.735, bias_95 CI=（-4.904 799, 3.878 029）1. Conclusion Compared to the nasogastric tube, mechanical ventilation in patients with indwelling nasogastrie tube, can significantly shorten the duration of mechanical ventilation, reduce the incidence of ventilator-associated pneumonia, and its efficacy, worthy of promotion.

关 键 词：机械通气 鼻空肠管 呼吸机相关性肺炎 Meta分析 

分 类 号：R459.6[医药卫生—治疗学]