经鼻高流量氧疗与持续正压通气治疗小儿肺炎疗效的Meta分析  

Curative effect of high-flow nasal cannula oxygen therapy and continuous positive airway pressure on infantile pneumonia:a Meta analysis

作　　者：邹宏鹏 徐建军[1] 毛宇昂 张小强[1] 宋超[1] 段传辉 ZOU Hongpeng;XU Jianjun;MAO Yuang;ZHANG Xiaoqiang;SONG Chao;DUAN Chuanhui(Department of Cardiothoracic Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China)

机构地区：[1]南昌大学第二附属医院心胸外科,南昌330006

出　　处：《重庆医学》2020年第8期1345-1349,共5页Chongqing medicine

摘　　要：目的分析经鼻高流量氧疗(HFNC)与持续正压通气(CPAP)治疗小儿肺炎的效果差异。方法通过维普数据库、万方数据库、中国知网(CNKI)、中国生物医学文献数据库(CBM)、Web Of Science、Embase、PubMed、the Cochrane Library、Science Direct搜索HFNC与CPAP在治疗小儿肺炎上的对比研究。结果共纳入7篇文献,共2026例患儿,其中HFNC组1027例,CPAP组999例。Meta分析结果显示,HFNC组在失败例数(95%CI:0.49~4.89,P=0.46),使用氧疗后第24小时呼吸下降频率(95%CI:-6.51~2.68,P=0.41),住院时间(95%CI:-6.51~2.68,P=0.41),氧疗时间上(95%CI:-0.23~0.12,P=0.54)与CPAP组比较,差异无统计学意义(P<0.05)。与CPAP组比较,HFNC组在使用氧疗后第24小时心率下降明显(95%CI:-9.80^-2.55,P=0.0008)。结论在治疗小儿肺炎的过程中,HFNC的安全性及疗效与CPAP相当,在控制心率上HFNC较CPAP优势更大。Objective To analyze the effect difference between high-flow nasal cannula oxygen therapy(HFNC)and continuous positive airway pressure(CPAP)in treating infantile pneumonia.Methods The comparative studies on HFNC and CPAP in the treatment of infantile pneumonia were retrieved from the VIP database,Wanfang database,CNKI,CBM,Web of Science,Embase,PubMed,the Cochrane Library,Science Direct.Results A total of 2026 children patients were included in 7 literatures,including 1027 cases in the HFNC group and 999 cases in the CPAP group.The results of meta analysis showed that there was no statistically significant difference between the HFNC group and the CPAP group in terms of failure cases(95%CI:0.49-4.89,P=0.46),the frequency of respiratory decline at 24 h after oxygen therapy(95%CI:-6.51-2.68,P=0.41),hospital stay(95%CI:-6.51-2.68,P=0.41),and the time of oxygen therapy(95%CI:-0.23-0.12,P=0.54).The heart rate at 24 h after oxygen therapy in the HFNC group was decreased significantly compared with the CPAP group(95%CI:-9.80--2.55,P=0.0008).Conclusion In the treatment of infantile pneumonia,the safety and efficacy of HFNC are similar to CPAP,and HFNC has more advantages in controlling heart rate than CPAP.

关 键 词：经鼻高流量氧疗 持续正压通气 小儿肺炎 META分析 

分 类 号：R563.1[医药卫生—呼吸系统]