高频震荡通气对新生儿呼吸窘迫综合征的治疗作用及其潜在危害性的Meta分析

Meta analysis of prospective clinical trials: high frequency oscillatory ventilation in the treatment of the neonatal respiratory distress ayndrome

摘要:

目的：综合比较高频震荡通气(HFOV)与传统机械通气(CMV)对新生儿呼吸窘迫综合征的治疗作用及其潜在危害性。方法：通过数据库检索出符合纳入分析条件的相关文献12篇,采用Meta分析方法进行定性、定量综合分析,得出合并OR值及其95％的可信区间。结果：与CMV相比,HFOV能明显改善呼吸窘迫综合征患儿的呼吸功能(P<0.05)以及降低慢性肺部疾病的发生率(P<0.01),但增加了新生儿颅内出血的危险性(P<0.05);在HFOV和CMV两种通气方式导致的气漏发生方面,则无明显差异(P>0.05)。结论：经用Meta分析认为应用HFOV治疗新生儿呼吸窘迫综合征的效果优于CMV,并可减少慢性肺部疾病的发生,但应注意新生儿颅内出血的并发症发生。

Abstract:

OBJECTIVE: To compare the therapeutic effect and complications of high frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) in neonates with the respiratory distress syndrome (RDS). METHODS: Meta analysis was used to evaluate the data extracted from 12 published papers. Combined Odds ratio (OR) and its 95% confidence interval were calculated. RESULTS: Compared to CMV, HFOV was found to improve pulmonary function ( P <0.05) and reduce the incidence of chronic lung disease (CLD) ( P <0.01). However, the use of HFOV resulted in an increase in intracranial hemorrhage (ICH) ( P <0.05) in infants with RDS. There was no difference in the incidence of air leak induced by HFOV and CMV. CONCLUSIONS: HFOV is more beneficial than CMV in its therapeutic effect on neonatal RDS and in its ability to reduce the incidence of CLD. This benefit may be offset by the increase in the occurrence of ICH when using this modality.