雾化吸入与气道滴注用于气管切开患者气道湿化效果的Meta分析  

Effects of aerosol inhalation and airway dripping for airway humidification in patients with tracheotomy:a Meta-analysis

作　　者：田梓蓉[1] 任晓波[2] 金晓婷[2] 南方[2] 安莹[3] 韩遵海 Tian Zirong;Ren Xiaobo;Jin Xiaoting;Nan Fang;An Ying;Han Zunhai(Nursing Department,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Otorhinolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Emergency Department,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Intensive Care Unit,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院护理部,100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730 [3]首都医科大学附属北京同仁医院急诊科,100730 [4]首都医科大学附属北京同仁医院中心ICU,100730

出　　处：《中华现代护理杂志》2021年第22期3006-3011,共6页Chinese Journal of Modern Nursing

基　　金：北京市属医院科研培育项目(PX2021009);中华医学会杂志社2019年护理学科研究课题(CMAPH-NRI2019033);北京同仁医院护理专项基金(2017-YJJ-HLL-009)。

摘　　要：目的评价雾化吸入与气道滴注用于气管切开患者气道湿化的效果,探索适合我国国情的气道湿化方式。方法计算机检索The Cochrane Library、PubMed、Embase、CNKI、万方、维普数据库中2010年1月—2020年10月发表的文献,纳入气管切开患者应用雾化吸入和气道滴注作为气道湿化方式的RCT。由2名研究者采用Cochrane Handbook(5.1.0.)的质量评价方法对文献质量进行严格评价和资料提取,对符合质量标准的文献进行Meta分析。结果共纳入12项RCT,共1010例患者。Meta分析结果显示,雾化吸入组的痰液黏稠度低于气道滴注组(RR=0.29,95%CI 0.21~0.40,P<0.01),气道黏膜损伤发生率、刺激性干咳发生率、肺部感染发生率亦降低(RR=0.34,95%CI 0.23~0.51,P<0.01;RR=0.24,95%CI 0.16~0.38,P<0.01;RR=0.48,95%CI 0.38~0.61,P<0.01),气道湿化效果优于气道滴注组(RR=0.1.34,95%CI 1.23~1.45,P<0.01)。结论采用雾化吸入对气管切开患者行气道湿化可显著降低痰液黏稠度、气道黏膜损伤、刺激性干咳、肺部感染,达到更好的气道湿化效果。Objective To evaluate the effect of aerosol inhalation and airway dripping for airway humidification of patients with tracheotomy,and explore airway humidification methods suitable for China's national conditions.Methods The documents published from January 2010 to October 2020 in The Cochrane Library,PubMed,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data and VIP were searched by computer,including randomized controlled trials(RCTs)on the application of aerosol inhalation and airway dripping as a method of airway humidification in patients with tracheotomy.Two researchers used the quality evaluation method of Cochrane Handbook(5.1.0.)to rigorously evaluate the quality of the documents and extract data,and conducted a meta-analysis of the documents that met the quality standards.Results A total of12 RCTs were included,with a total of 1010 patients.The results of meta-analysis showed that the sputum viscosity in the aerosol inhalation group was lower than that in the airway dripping group[RR=0.29,95%CI(0.21,0.40),P<0.01],the incidences of airway mucosal injury,irritating dry cough and lung infection also decreased[RR=0.34,95%CI(0.23,0.51),P<0.01;RR=0.24,95%CI(0.16,0.38),P<0.01;RR=0.48,95%CI(0.38,0.61),P<0.01],the airway humidification effect was better than that of the airway dripping group[RR=0.1.34,95%CI(1.23,1.45),P<0.01].Conclusions The application of aerosol inhalation to humidify the airway in patients with tracheotomy can significantly reduce the sputum viscosity,airway mucosal injury,irritating dry cough,and the lung infection,and achieve a good airway humidification effect.

关 键 词：气管切开术 气道湿化 气道滴注 雾化吸入 META分析 

分 类 号：R653[医药卫生—外科学]