Early Intratracheal Administration of Corticosteroid and Pulmonary Surfactant for Preventing Bronchopulmonary Dysplasia in Preterm Infants with Neonatal Respiratory Distress Syndrome: A Meta-analysis  

作　　者：Yan-yan ZHONG Jin-chun LI Ya-ling LIU Xiao-bo ZHAO Musa MALE Dong-kui SONG Yan BAI 

机构地区：[1]Department of Pediatrics, Huazhong University of Science and Technology Hospital, Wuhan 430074,China [2]Neonatal Intensive Care Unit, Hubei Maternity and Children's Hospital, Wuhan 430070,China [3]Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology,Wuhan 430022, China [4]Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology,Wuhan 430030, China

出　　处：《Current Medical Science》2019年第3期493-499,共7页当代医学科学（英文）

摘　　要：There is uncertain result with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. This meta-analysis was designed to evaluate the efficacy and safety of early airway administration (within 2 days after birth) of corticosteroids and pulmonary surfactant (PS) for preventing bronchopulmonary dysplasia (BPD) in premature infants with neonatal respiratory distress syndrome (NRDS). The related studies were retrieved in PubMed, EMBASE, the Cochrane Library, Clinical Trial, CNKI, Wanfang and VIP Database from inception to August 2018. Two reviewers independently screened the studies to ensure that all patients with diagnosis of NRDS were enrolled to studies within 1 day after birth, assessed the quality of included studies by GRADEpro system and extracted the data for review. The meta-analysis was performed by RevMan 5.2 software. A subgroup analysis about inhaled corticosteroid (ICS) delivery method was made between ICS inhalation subgroup [inhalation of ICS by nebulizer or metered dose inhaler (MDI)] and ICS intratracheal instillation subgroup (PS used as a vehicle). Eight randomized controlled trials were enrolled in the meta-analysis, 5 trials of which stated the randomized method, grouping and blinded method, and the follow-up procedures were reported. GRADEpro system showed high quality of 4 trials (5 articles), and the rest 4 trials had moderate quality. Meta-analysis showed that the incidence of BPD was decreased in ICS group, the relative risk (RR) was 0.56 (95% CI: 0.42-0.76), and similar trends were found in ICS inhalation subgroup and ICS intratracheal instillation subgroup, with the corresponding RR being 0.58 (95% CI: 0.41-0.82) and 0.47 (95% CI: 0.24-0.95) respectively. ICS could also significantly reduce the mortality risk as compared with placebo control group (RR: 0.67;95% CI: 0.45-0.99), with RR of ICS inhalation subgroup and ICS intratracheal instillation subgroup being 0.81 (95% CI: 0.34-1.94) and 0.64 (95% CI: 0.41-0.99) respectively. M

关 键 词：CORTICOSTEROID pulmonary surfactant PRETERM infants BRONCHOPULMONARY DYSPLASIA neonatal respiratory DISTRESS syndrome META-ANALYSIS 

分 类 号：R[医药卫生]