气道压力释放通气对急性呼吸窘迫综合征患者住院病死率影响的累积Meta分析  

Effect of airway pressure release ventilation on the hospital mortality of patients with acute respiratory distress syndrome:a cumulative meta-analysis

作　　者：岳伟岗[1] 蒋由飞 袁鹏[1] 尹瑞元 冯鑫 张志刚[1] 田金徽[2] 李斌[1] YUE Weigang;JIANG Youfei;YUAN Peng;YIN Ruiyuan;FENG Xin;ZHANG Zhigang;TIAN Jinhui;LI Bin(Department of Critical Care Medicine,the First Hospital of Lanzhou University,Lanzhou 730000,P.R.China;Evidence Based Medicine Center of Lanzhou University,Key Laboratory of Evidence Based Medicine and Clinical Transformation of Gansu Province,Lanzhou 730000,P.R.China)

机构地区：[1]兰州大学第一医院重症医学科,兰州730000 [2]兰州大学循证医学中心、甘肃省循证医学与临床转化重点实验室,兰州730000

出　　处：《中国循证医学杂志》2023年第5期517-521,共5页Chinese Journal of Evidence-based Medicine

基　　金：兰州市科技计划项目(编号:2020-ZD-78);兰州大学第一医院院内基金(编号:ldyyyn-2019-68)。

摘　　要：目的应用累积Meta分析的方法评价气道压力释放通气(APRV)对急性呼吸窘迫综合征(ARDS)患者住院病死率的影响。方法计算机检索PubMed、Web of Science、Cochrane Library、WanFang Data、CNKI和VIP数据库,搜集与研究目的相关的随机对照试验(RCT),检索时限均为建库至2022年6月30日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用StataSE 12.0软件进行累积Meta分析。结果共纳入9个RCT,包括533例患者。Meta分析结果显示,与传统机械通气相比,APRV能够降低ARDS患者的住院病死率[RR=0.70,95%CI(0.54,0.91),P<0.01]。结论当前证据表明,APRV可降低ARDS患者住院病死率。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。Objective To evaluate the effect of airway pressure release ventilation(APRV)on the hospital mortality of patients with acute respiratory distress syndrome(ARDS)by using cumulative meta-analysis.Methods The PubMed,Web of Science,Cochrane Library,WanFang Data,CNKI,and VIP databases were electronically searched to collect randomized controlled trials(RCTs)related to the objective from inception to June 30,2022.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.A cumulative meta-analysis was then performed by using StataSE 12.0 software.Results A total of 9 RCTs involving 533 patients were included.The results of meta-analysis showed that APRV could reduce the hospital mortality of patients with ARDS(RR=0.70,95%CI 0.54 to 0.91,P<0.01)compared with traditional mechanical ventilation.Conclusion Current evidence shows that APRV can reduce the hospital mortality of patients with ARDS.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.

关 键 词：气道压力释放通气 传统机械通气 急性呼吸窘迫综合征 累积Meta分析 系统评价 

分 类 号：R563.8[医药卫生—呼吸系统]