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中华危重症医学杂志(电子版) ›› 2022, Vol. 15 ›› Issue (02) : 135 -140. doi: 10.3877/cma.j.issn.1674-6880.2022.02.009

荟萃分析

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
任秋艳1,(), 甄军海1, 吴亮1   
  1. 1. 310013 杭州,浙江医院重症医学科
  • 收稿日期:2021-12-11 出版日期:2022-04-30
  • 通信作者: 任秋艳
  • 基金资助:
    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)

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

Qiuyan Ren1,(), Junhai Zhen1, Liang Wu1   

  1. 1. Department of Intensive Care Unit, Zhejiang Hospital, Hangzhou 310013, China
  • Received:2021-12-11 Published:2022-04-30
  • Corresponding author: Qiuyan Ren
引用本文:

任秋艳, 甄军海, 吴亮. 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[J/OL]. 中华危重症医学杂志(电子版), 2022, 15(02): 135-140.

Qiuyan Ren, Junhai Zhen, Liang Wu. Efficacy of airway pressure release ventilation in patients with acute respiratory distress syndrome: a meta-analysis[J/OL]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2022, 15(02): 135-140.

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.

表1 纳入研究的基本特征
表2 纳入研究的方法学评价
图1 两组ARDS患者通气后氧合指数比较的森林图注:ARDS.急性呼吸窘迫综合征;APRV.气道压力释放通气;MD.标准差;CI.置信区间
图2 两组ARDS患者通气后28 d病死率比较的森林图注:ARDS.急性呼吸窘迫综合征;APRV.气道压力释放通气;OR.比值比;CI.置信区间
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