经鼻高流量氧疗在成人气管插管患者拔管后应用效果的Meta分析  

Effects of high-flow nasal cannulae in patients with tracheal intubation after extubation： a Meta analysis

作　　者：查丽玲[1] 周松[3] 江榕[1] 王建宁[2] 

机构地区：[1]南昌大学第一附属医院重症医学科,南昌330006 [2]南昌大学护理学院,330006 [3]南昌大学第一附属医院护理部,南昌330006

出　　处：《中华现代护理杂志》2017年第23期3011-3015,共5页Chinese Journal of Modern Nursing

基　　金：江西省教育厅科学技术研究项目（60248）

摘　　要：目的 探讨经鼻高流量氧疗（HFNC）在气管插管患者拔管后的应用效果.方法 计算机检索Cochrane library、PubMed、Ovid Medline、Web of Science、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库、维普数据库（VIP）中有关HFNC在气管插管患者拔管后应用效果的临床对照试验,经筛选文献,提取资料与评价质量后采用RevMan 5.3软件进行统计分析.结果 最终纳入4篇随机对照试验、1篇临床对照试验,共1515例患者.Meta分析结果显示,与其他氧疗方式比较,HFNC可以降低气管插管患者拔管后低氧血症发生率[OR=0.52,95%CI（0.35,0.79）,P=0.002],患者舒适度及耐受性优于其他氧疗方式,但不能降低ICU病死率[OR=1.12,95%CI（0.67,1.88）,P=0.67].结论 HFNC可以降低气管插管患者拔管后低氧血症发生率,HFNC舒适度良好,患者更易耐受,不能降低ICU病死率,对气管插管重插率的影响还需进一步验证.Objective To investigate the effect of high-flow nasal cannula （HFNC） in patients with tracheal intubation after extubation.Methods We searched controlled clinical trials related to the effect of HFNC in patients with tracheal intubation after extubation among Cochrane library, PubMed, Ovid Medline, Web of Science, China Biology Medicine disc, （CBM disc）, China National Knowledge Internet （CNKI）, Wanfang Database and VIP Database （VIP）. By literature screening, data extraction and assessment the quality, the selected papers were analyzed by RevMan 5.3 software.Results A total of 4 randomized controlled trials and 1 randomized controlled trials with a total of 1515 subjects were included in the study. According to Meta analysis, comparing with other oxygen therapy, HFNC could significantly reduce the incidence rate of hypoxemia in patients with tracheal intubation after extubation [OR=0.52,95%CI（0.35,0.79）,P=0.002], the patient＇s comfort and tolerance were better than those of other oxygen therapy but mortality rate of ICU could not be reduced [OR=1.12,95%CI（0.67,1.88）,P=0.67].Conclusions HFNC can reduce the incidence rate of hypoxemia in patients with tracheal intubation after extubation. HFNC has good comfort and is more tolerable for patients. It could not decrease mortality rate of ICU and its effect on reintubation rate for tracheal intubation patients also need further verification.

关 键 词：经鼻高流量氧疗 气管插管患者 拔管后 应用效果 META分析 

分 类 号：R472[医药卫生—护理学]