经鼻高频通气治疗新生儿呼吸窘迫综合征效果的系统评价  

Clinical efficacy of nasal high-frequency ventilation in treatment of neonatal respiratory distress syndrome: a Meta analysis

作　　者：杨玉兰 吴本清 苏锦珍 杨琳 钟桂朝 刘兰 YANG Yu-Lan;WU Ben-Qing;SU Jin-Zhen;YANG Lin;ZHONG GUI-Chao;LIU Lan(Department of Neonatology,Second Clinical Medical College of Jinan University,Shenzhen People＇s Hospital,Shenzhen,Guangdong 518020,China)

机构地区：[1]暨南大学第二临床医学院深圳市人民医院新生儿科,广东深圳518020 [2]中国科学院大学深圳医院新生儿科,广东深圳518000

出　　处：《中国当代儿科杂志》2018年第11期897-903,共7页Chinese Journal of Contemporary Pediatrics

摘　　要：目的对经鼻高频通气(nHFV)治疗新生儿呼吸窘迫综合征(NRDS)的治疗效果进行系统评价,为临床提供循证证据。方法计算机检索PubMed、Cochrane图书馆、EMBase(Ovid)、中国生物医学文献数据库、中国期刊全文数据库、万方数据库和中文科技期刊数据库,收集n HFV对比经鼻持续正压通气(nCPAP)治疗NRDS的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取,并参考Cochrane系统评价员手册5.1.0进行质量评价,然后采用Rev Man5.3统计软件进行Meta分析。结果共纳入4项RCT,合计218例患儿。Meta分析结果显示,与n CPAP组比较,nHFV组获得更有效的治疗效果(RR=1.73,95%CI:1.39～2.15,P<0.00001)。两组患儿脑室内出血、脑室周围白质软化、支气管肺发育不良、坏死性小肠结肠炎、气胸、早产儿视网膜病等并发症的发生率无明显差异。结论目前证据表明,与n CPAP相比,nHFV对NRDS的治疗效果更好,并无增加相关并发症的风险。Objective To systematically evaluate the clinical efficacy of nasal high-frequency ventilation（nHFV） in the treatment of neonatal respiratory distress syndrome（NRDS）. Methods A literature search was performed in PubMed, Cochrane Library, EMBase（Ovid）, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Wanfang Data, and Weipu Data to collect the randomized controlled trials（RCTs） that compared the clinical efficacy of nHFV and nasal continuous positive airway pressure（nCPAP） in the treatment of NRDS. A Meta analysis was performed on the included RCTs using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane 5.1.0. Results A total of 4 RCTs involving 218 patients were included. The Meta analysis showed that compared with the nCPAP group, the nHFV group had a significantly better treatment outcome（RR=1.73, 95%CI： 1.39-2.15, P0.00001）. There were no significant differences in the incidence rates of intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, necrotizing enterocolitis, pneumothorax and retinopathy of prematurity. Conclusions Compared with nCPAP, nHFV has better clinical efficacy in the treatment of NRDS, without increasing the risk of related complications.

关 键 词：经鼻高频通气 无创高频通气 呼吸窘迫综合征 META分析 新生儿 

分 类 号：R722.1[医药卫生—儿科]