气道压力释放通气对急性呼吸窘迫综合征患者疗效的Meta分析  

Efficacy of airway pressure release ventilation in patients with acute respiratory distress syndrome: a meta-analysis

作　　者：任秋艳 甄军海 吴亮[1] Ren Qiuyan;Zhen Junhai;Wu Liang(Department of Intensive Care Unit,Zhejiang Hospital,Hangzhou 310013,China)

机构地区：[1]浙江医院重症医学科,杭州310013

出　　处：《中华危重症医学杂志（电子版）》2022年第2期135-140,共6页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：2017年浙江省医药卫生科研基金项目(2017KY186);2020年浙江省医药卫生科技计划项目(2020KY001)。

摘　　要：目的:系统评价气道压力释放通气(APRV)治疗急性呼吸窘迫综合征(ARDS)患者的疗效。方法:计算机检索Cochrane Library、PubMed、Embase、中国生物医学文献数据库、中国知网、万方数据库,查找关于APRV与常规机械通气对比治疗ARDS患者的随机对照试验(RCTs),检索时限从建库到2021年3月。由2名研究者按照纳入与排除标准筛选文献、提取数据和评价质量后,采用RevMan 5.2软件和Stata 1.4软件进行Meta分析。结果:共纳入11项RCTs,合计611例患者。Meta结果显示,治疗后,APRV组ARDS患者的氧合指数高于对照组[均数差(MD)=31.70,95%置信区间(CI)(3.76,59.63),Z=2.22,P=0.03],且APRV组患者28 d病死率显著低于对照组[比值比(OR)=0.55,95%CI(0.36,0.84),Z=2.77,P=0.006]。结论:对于ARDS患者而言,早期应用APRV能够增加氧合功能,降低28 d病死率。Objective:To evaluate the efficacy of airway pressure release ventilation(APRV)in patients with acute respiratory distress syndrome(ARDS).Methods:The randomized controlled trials(RCTs)about the APRV and conventional mechanical ventilation for the treatment of ARDS patients were retrieved from Cochrane Library,PubMed,Embase,CBM,CNKI,Wangfang databases published up to March 2021.According to the inclusion and exclusion criteria,two researchers shifted the literatures,extracted the data and evaluated the methodological quality of the studies.Meta-analysis was performed using RevMan 5.2 software and Stata 1.4 software.Results:A total of 11 RCTs were included in this study with 611 patients.The results of meta-analysis showed that the oxygenation index in the APRV group was much higher than that in the control group[mean difference(MD)=31.70,95%confidence interval(CI)(3.76,59.63),Z=2.22,P=0.03],while the 28-day mortality was much lower[odds ratio(OR)=0.55,95%CI(0.36,0.84),Z=2.77,P=0.006].Conclusion:For the patients with ARDS,early application of APRV can improve oxygenation and reduce 28-day mortality.

关 键 词：呼吸窘迫综合征 气道压力释放通气 META分析 

分 类 号：R563.8[医药卫生—呼吸系统]