持续性肺膨胀在<34周早产儿中应用的Meta分析  

Application of sustained lung inflation in preterm infants with a gestational age of<34 weeks:a Meta analysis

作　　者：李敏许[1] 邓皓辉[1] 苏锦珍 阮敏仪[1] 杨勇[1] LI Min-Xu;DENG Hao-Hui;SU Jin-Zhen;RUAN Min-Yi;YANG Yong(Department of Neonatology,Dongguan Maternal and Child Health Hospital,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞市妇幼保健院新生儿科,广东东莞523000

出　　处：《中国当代儿科杂志》2020年第3期245-250,共6页Chinese Journal of Contemporary Pediatrics

基　　金：广东省东莞市社会科技发展(重点)项目(201750715007468)。

摘　　要：目的对持续性肺膨胀(SLI)在<34周早产儿中的应用效果进行系统评价.方法计算机检索PubMed、Embase、Cochrane图书馆、中国知网、万方数据库、中国生物医学文献数据库、中国期刊全文数据库、中国科技期刊数据库,收集SLI对比单纯无创正压通气运用于早产儿的随机对照研究,采用Revman 5.3统计软件对符合纳入标准的临床研究进行Meta分析.结果共纳入9项随机对照研究,合计1432例早产儿(胎龄:23~33.7周).Meta分析结果显示:与对照组相比,SLI组72 h内需机械通气率较对照组低(51.9%vs 56.9%;RR=0.91,P=0.04,95%CI:0.83~0.99);两组病死率、肺表面活性物质使用率及相关并发症发生率(支气管肺发育不良、气胸、Ⅲ~Ⅳ级颅内出血)差异无统计学意义(P>0.05).结论SLI可减低<34周早产儿机械通气的使用,且未增加其余相关并发症的风险.Objective To systematically review the effect of sustained lung inflation(SLI)in preterm infants with a gestational age of<34 weeks.Methods PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,China Biology Medicine disc,Chinese Journal Full-text Database,and Weipu Database were searched for randomized controlled trials(RCTs)on the application of SLI versus noninvasive positive pressure ventilation alone in preterm infants.Revman 5.3 was used to perform a Meta analysis for the RCTs which met the inclusion criteria.Results A total of 9 RCTs were included,with 1432 preterm infants in total(with a gestational age of 23-33.7 weeks).The Meta analysis showed that compared with the control group,the SLI group had a significantly lower proportion of the infants who needed mechanical ventilation within 72 hours(51.9%vs 56.9%,RR=0.91,P=0.04,95%CI:0.83-0.99).There were no significant differences between the two groups in the mortality rate,rate of use of pulmonary surfactant,and incidence rates of related complications(bronchopulmonary dysplasia,pneumothorax,and grade III-IV intracranial hemorrhage)(P>0.05).Conclusions SLI can reduce the use of mechanical ventilation in preterm infants with a gestational age of<34 weeks and does not increase the risk of other complications.

关 键 词：持续性肺膨胀 META分析 早产儿 

分 类 号：R722.6[医药卫生—儿科]