ISSN 2096-7446　CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2020, Vol. 1 ›› Issue (6): 529-535.

• 证据综合与应用 • 上一篇    下一篇

高流量鼻导管氧疗对机械通气患者拔管后影响的Meta分析

翟怀香 徐萍 苗晓   

  1. 连云港市第一人民医院重症监护室
  • 收稿日期:2020-07-20 出版日期:2020-11-10 发布日期:2020-11-27

Meta-analysis of the effect of high-flow nasal cannula oxygen therapy after extubation in patients undergoing mechanical ventilation

ZHAI Huaixiang, XU Ping, MIAO Xiao   

  • Received:2020-07-20 Online:2020-11-10 Published:2020-11-27

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摘要：

目的：系统评价高流量鼻导管氧疗对机械通气患者拔管后的影响。方法检 索Cochrane Library 、Joanna Briggs Institute Library (JBI)、PubMed 、MEDLINE、Embase、CINAHL、中国知网、 维普数据库、中国生物医学文献数据库及万方数据库中关于高流量鼻导管氧疗对机械通气患者拔管后影响的随机对照试验。经筛选文献提取资料与评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果共纳入14项 随机对照试验,3 375例患者。Meta分析显示，高流量鼻导管氧疗在降低患者再插管率[95%CI(0.52,1.22),Z=1.03,P=0.30]、降低患者病死率[95%CI(0.79, 1.56), .Z=0.61, P=0.45]、缩短ICU住院时间[95%CI(-1 .53, 1.27) ,z=0.18, P=0.86]以及降低痰痂发生率[95%CI(0.01, 1.88),Z=1.47,P=0.14]方面无明显优势,对降低肺部感染发生率[ 95%CI(0.13 ,0.70),Z=2.78,P=0.005]具有一定作用。结论：经鼻高流量氧疗与常规氧疗比较,可以降低肺部感染发生率,但并不能降低患者的再插管率、ICU病死率、痰痂发生率、不能缩短ICU住院时间。

关键词:

鼻导管给氧, 高流量氧疗, 机械通气;拔管, Meta分析

Abstract:

Objective To systematically evaluate the effect of high-1low nasal cannula oxy gen therapy after extubation in patients undergoing mechanical ventilation. Methods We searched Cochrane Library , Joanna Briggs Institute Library (JBI), Pubmed ,MEDLIN E, Embase ,CINAHL,CNKI, VIP Database , China Biomedical Literature Database (CBM) and W anfang Database for randomized controlled trials on the effects of high-flow nasal catheter oxygen therapy after extubation in patients undergoing mechanical ventilation. After screening the literature , extracting data and evaluating literature quality , RevMan 5.3 software was used for meta-analysis. Results A total of 14 randomized controlled trials and 3, 375 patients were included. Meta-analysis showed that high-flow nasal catheter oxygen therapy had no advantage in reducing patient reintubation rate[ 95%Cl(0.52, 1.22) ,Z= 1.03, P=0.30], reducing patient mortality[95%CI(0.79, 1.56), Z=0.61 ,P=0.45],shortening the ICU length of stay[95%CI(-1.53, 1.27) ,Z=0.18, P=0.86] and .the incidence of spittoon [95%CI (0.01,1 .88),Z=1.47 ,P=0.14],and had some effects in reducing the incidence of pulmonary infection. Conclusion Compared with conventional oxygen therapy , nasal high-flow oxygen therapy can reduce the incidence of pulmonary infection,but it cannot reduce the patient's re intubation rate, ICU mortality incidence of spittoon and the ICU length of stay.

Key words:

Nasal Catheter Oxygen Inhalation, High-flow Oxygen Therapy, Mechanical Ventilation;Extubation;Meta-analysis