预防应激性溃疡对呼吸机相关肺炎影响的Meta分析  

Meta analysis of the effect of prevention of stress ulcer on ventilator-associated pneumonia

作　　者：蒙波 徐强 赵璇[3] 马佳佳[3] 韩娟[3] MENG Bo;XU Qiang;ZHAO Xuan;MA Jiajia;HAN Juan(Emergency Department,Xi'an Fengcheng Hospital,Xi'an 710016;Critical Care Medicine Department,the Second People's Hospital of Ning County,Qingyang 745200;Critical Care Medicine Department,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710016,China)

机构地区：[1]西安凤城医院急诊科,陕西西安710016 [2]甘肃省庆阳市宁县第二人民医院重症医学科,甘肃庆阳745200 [3]西安交通大学第一附属医院重症医学科,陕西西安710016

出　　处：《临床医学研究与实践》2020年第22期8-11,共4页Clinical Research and Practice

摘　　要：目的探讨预防应激性溃疡对呼吸机相关性肺炎(VAP)的发生及患者预后的影响。方法利用计算机对中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方数据库、PubMed、EMBASE、Cochrane library等中外文相关医学数据库进行文献检索,检索时间为1990年1月至2019年8月。对符合纳入标准的医学文献使用Review Manager5.2统计学软件进行结果分析。结果最终共纳入文献4篇,包括283例患者,其中干预组(应激性溃疡预防组)161例,对照组(安慰剂或不干预组)122例。Meta分析结果显示,两组间VAP发生率比较,差异无统计学意义(RR=1.39,95%CI为0.98~1.97,P=0.06);两组间VAP病死率比较,差异无统计学意义(RR=1.25,95%CI为0.63~2.48,P=0.52);两组应激性溃疡发生率比较,差异无统计学意义(RR=0.68,95%CI为0.19~2.47,P=0.56)。结论对于机械通气患者,常规预防应激性溃疡不能降低VAP及应激性溃疡的发生率。Objective To investigate the effects of prevention of stress ulcer on the occurrence of ventilator-associated pneumonia(VAP)and patients’prognosis.Methods The literatures that were published in Chinese and foreign relevant medical databases,such as CBM,CNKI,Wanfang,PubMed,EMBASE and Cochrane Library from January 1990 to August2019 were retrieved by computer.The Review Manager 5.2 statistical software was used to analyze the results of medical literatures that met the inclusion criteria.Results Finally,four articles were included,including 283 patients,161 cases in the intervention group(stress ulcer prevention group)and 122 cases in the control group(placebo or non-intervention group).Meta analysis results showed that there was no significant difference in the incidence of VAP between the two groups(RR=1.39,95%CI was 0.98-1.97,P=0.06);there was no significant difference in the mortality of VAP between the two groups(RR=1.25,95%CI was 0.63-2.48,P=0.52);there was no significant difference in the incidence of stress ulcer between the two groups(RR=0.68,95%CI was 0.19-2.47,P=0.56).Conclusion For mechanical ventilation patients,routine prevention of stress ulcer can not reduce the incidences of VAP and stress ulcer.

关 键 词：应激性溃疡 呼吸机相关性肺炎 质子泵抑制剂 META分析 

分 类 号：R563.19[医药卫生—呼吸系统]