吸入氧浓度自动控制系统在早产儿氧疗中的应用:系统评价及Meta分析  

Application of Automated Control System of Inspired Oxygen in Oxygen Therapy of Preterm Infants:A Systematic Review and Meta-analysis

作　　者：林玉平 胡丽风 吴雪华 胡美瑜 魏自辉 谢礼斌 LIN Yuping;HU Lifeng;WU Xuehua;HU Meiyu;WEI Zihui;XIE Libin(Department of Neonatology,Fuzhou Second General Hospital,Fuzhou,Fujian,350007,China;Department of Neonatology,Fuzhou Second General Maternity and Child Health Care Hospital,Fuzhou,Fujian,350013,China)

机构地区：[1]福州市第二总医院新生儿科,福建福州350007 [2]福州市第二总医院妇幼保健院新生儿科,福建福州350013

出　　处：《中外医疗》2024年第35期48-56,共9页China & Foreign Medical Treatment

基　　金：福州市“十四五”临床专科培强培优培育建设项目(20220205)。

摘　　要：目的系统评价吸入氧浓度自动控制系统在早产儿氧疗中的应用价值。方法检索PubMed、EMBASE、Web of Science,Cochrane图书馆、CINAHL数据库、ClinicalTrials.gov、中国期刊全文数据库、中国维普数据库、万方全文数据库2019年3月—2020年3月期间的文献。纳入在早产儿中比较吸入氧浓度自动控制与手动控制系统的随机对照试验,采用Revman 5.3软件进行Meta分析。结果共检索到文献387篇,最终纳入12篇随机对照研究,包括333名早产儿。Meta分析结果提示,自动控制组早产儿的脉搏血氧饱和度处于目标范围的时间长于手动控制组,差异有统计学意义(P<0.001)。自动控制组严重低氧时间短于手动控制组,差异有统计学意义(P<0.001)。自动控制组严重高氧时间短于手动控制组,差异有统计学意义(P<0.001)。两组平均手动控制吸入氧浓度比较,差异无统计学意义(P>0.05)。自动控制组每小时人工调节频次少于手动控制组,差异有统计学意义(P<0.001)。结论吸入氧浓度自动控制系统显著提高早产儿处于目标血氧饱和度范围内的时间,缩短高氧和严重低氧发作时间,并减轻了护理人员的工作量。但目前最佳的吸入氧浓度自动控制系统及其对远期预后的影响还需更进一步的研究。Objective To systematically evaluate the application value of the automatic control system of inspired oxygen in premature infants.Methods Search for documents from PubMed,EMBASE,Web of Science,Cochrane Library,CINAHL Database,ClinicalTrials.gov,China National Knowledge Infrastructure(CNKI),China Weipu Database(VIP),and Wanfang Full-text Database from March 2019 to March 2020 Randomized controlled trials comparing the automatic and manual fraction of inspired oxygen(FiO2)control system in preterm infants were included.The RevMan 5.3 software was used for Meta-analysis.Results A total of 387 literatures were retrieved,and 12 randomized controlled studies were included,including 333 preterm infants.The results of Meta-analysis suggested that the pulse oxygen saturation of preterm infants in the automatic control group was in the target range for a longer time than that in the manual control group,and the difference was statistically significant(P<0.001).The duration of severe hypoxia in the automatic control group was shorter than that in the manual control group,and the difference was statistically significant(P<0.001).The duration of severe hyperxia in the automatic control group was shorter than that in the manual control group,and the difference was statistically significant(P<0.001).There was no significant difference in the average manual control of inhaled oxygen concentration between the two groups(P>0.05).The frequency of manual adjustment per hour in the automatic control group was less than that in the manual control group,and the difference was statistically significant(P<0.001).Conclusion The automated control system of inhaled oxygen concentration can significantly increase the duration of premature infants in the target oxygen pulse saturation range,shorten the onset time of hyperxia and severe hypoxia,and reduce the workload of nursing staff.However,the optimal automatic control system of inhaled oxygen concentration and its effect on long-term prognosis need further study.

关 键 词：自动控制 闭环 氧气 早产儿 META分析 

分 类 号：R722[医药卫生—儿科]