江汉大学学报(自然科学版) ›› 2023, Vol. 51 ›› Issue (4): 87-96.doi: 10.16389/j.cnki.cn42-1737/n.2023.04.011

• 医学 • 上一篇    

俯卧位通气治疗新生儿呼吸窘迫综合征并发症风险的Meta分析

范飞燕1 ,姜赤秋*2   

  1. 1. 江汉大学 医学部,湖北 武汉 430056;2. 湖北省第三人民医院 新生儿科,湖北 武汉 430030
  • 发布日期:2023-08-19
  • 通讯作者: 姜赤秋
  • 作者简介:范飞燕(1995- ),女,硕士生,研究方向:危重新生儿救治。

The Complications Risk of Prone Position Ventilation Treating Neonatal Respiratory Distress Syndrome:A Meta-analysis

FAN Feiyan1 ,JIANG Chiqiu*2   

  1. 1. School of Medicine,Jianghan University,Wuhan 430056,Hubei,China;2. Neonatal Department,The Third People's Hospital of Hubei Province,Wuhan 430030,Hubei,China
  • Published:2023-08-19
  • Contact: JIANG Chiqiu

摘要: 目 的 探讨俯卧位通气(prone position ventilation,PPV)对新生儿呼吸窘迫综合征 (neonatal respiratory distress syndrome,NRDS)并发症风险发生的影响。方 法 由两位研究者确 定检索方法和纳入标准,分别对 PubMed、EMBASE、Web of Science、中国生物医学文献数据库、 中国知网、万方和维普等数据库中 PPV 对 NRDS 机械通气患儿影响的相关文献进行检索。从中 筛选出符合纳入标准的文献,进行质量等级划分和提取有用的信息资料,最后运用 RevMan 5.3 软件进行循证医学分析。结 果 最终符合纳入标准的研究有 12 项,涵盖 1 246 例研究对象。Meta 分析的结果表明:仰卧位组在压疮、意外拔管、呼吸机相关性肺炎、气胸、肺出血、皮下水肿、颅内 出血风险的发生率均高于间断 PPV 组(P ≤ 0. 05);两组在人工气道堵塞风险发生率方面无明显 差异(P > 0. 05)。结 论 PPV 可降低 NRDS 患儿压疮、意外拔管、呼吸机相关性肺炎、气胸、肺 出血、皮下水肿、颅内出血风险的发生率,但并不影响人工气道堵塞风险的发生率,可为新生儿科 开展 PPV 工作的安全性提供相应的证据参考。

关键词: 俯卧位通气, 新生儿呼吸窘迫综合征, 并发症, Meta 分析

Abstract: Objective To discuss the influence of prone position ventilation(PPV) on the complications risk of neonatal respiratory distress syndrome (NRDS). Methods The two researchers jointly formulated retrieval strategies and inclusion criteria. Relevant clinical controlled trials on the application effect of PPV on NRDS mechanical ventilation in newborns were searched from PubMed,EMBASE,Web of Science,China Biomedical Literature Database,CNKI,Wanfang,and VIP databases,respectively. The literature that met the inclusion criteria was screened out,the quality grade was divided,and valuable information was extracted. Finally,RevMan 5.3 software was used for evidence-based medicine analysis. Results 12 pieces of literature ultimately met the inclusion criteria, covering 1 246 subjects. The Meta-analysis results showed that the risk of pressure ulcers, accidental extubation, ventilator-associated pneumonia, pneumothorax, pulmonary hemorrhage,subcutaneous edema,and intracranial hemorrhage in the supine group was higher than those in the PPV group(P ≤ 0. 05). There was no significant difference in the risk of artificial airway blockage between the two groups(P > 0. 05). Conclusion PPV can reduce the risk of pressure ulcers,accidental extubation,ventilator-associated pneumonia, pneumothorax,pulmonary hemorrhage,subcutaneous edema,and intracranial hemorrhage in newborns with NRDS,but does not affect the risk of artificial airway blockage. This study can provide evidence reference for the safety of PPV in neonatology.

Key words: prone position ventilation, neonatal respiratory distress syndrome, complications, Meta-analysis

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