摘要
目的：采用meta分析的方法对允许性高碳酸血症是否增加机械通气早产儿脑损伤风险,甚至影响神经发育进行评价。方法：全面检索PubMed、Ovid、Web of Science、Embase Cochrane Library、中国生物医学文献数据库（CBM）,中国期刊全文数据库（CNKI）,中文科技期刊数据库（VIP）和万方数据库。收集所有关于机械通气早产儿应用允许性高碳酸血症的临床随机对照研究的相关文献并进行筛选,对纳入研究的文献进行质量评价,应用Stata 12.0软件对资料进行Meta分析。结果：共纳入9篇临床随机对照试验（RCT）。总样本量678例,其中允许性高碳酸血症组342例,常规治疗组336例。允许性高碳酸血症组较对照组脑室内出血（IVH）、3～4级IVH、脑室周围白质软化（PVL）、脑瘫、智力损害（MDI〈70）、运动损害（PDI〈70）发生率差异无统计学意义,OR值及95%CI分别为0.83（0.52,1.33）、0.79（0.49,1.28）、1.02（0.47,2.21）、0.66（0.33,1.32）、1.23（0.80,1.88）、1.10（0.69,1.76）。结论：允许性高碳酸血症不增加机械通气早产儿脑损伤的风险,亦不损害早产儿脑神经发育。
Objective： To evaluate whether permissive hypercapnia（ PHC） can increase the risk of cerebral injury of premature infants with mechanical ventilation,even affect neurodevelopment. Methods： PubMed,Ovid,Web of Science,Embase Cochrane Library,CBM,CNKI,VIP and Wanfang Database were searched comprehensively. All the literatures about randomized controlled clinical studies of mechanical ventilation in premature infants with permissive hypercapnia were collected and screened,the quality of included literatures was evaluated,Stata 12. 0 software was used for Meta analysis. Results： Nine randomized controlled trials（ RCT） were included in this study（ 678 cases）,342 cases with PHC and 336 cases in conventional therapy group were included. There was no statistically significant difference in the incidence rates of intraventricular hemorrhage（ IVH）,severe IVH,periventricular leukomalacia（ PVL）,cerebral palsy,mental damage（ MDI 70） and motor impairment（ PDI 70） between PHC group and control group 〔OR values： 0. 83,0. 79,1. 02,0. 66,1. 23,1. 10; 95% CI values：（ 0. 52,1. 33）,（ 0. 49,1. 28）,（ 0. 47,2. 21）,（ 0. 33,1. 32）,（ 0. 80,1. 88）,（ 0. 69,1. 76） 〕. Conclusion： PHC does not increase the risk of cerebral injury in premature infants with mechanical ventilation,and it has no impact on neurodevelopment of premature infants.
出处
《中国妇幼保健》
CAS
北大核心
2014年第27期4414-4418,共5页
Maternal and Child Health Care of China
基金
江苏省科技创新与成果转化(生命健康科技)专项资金〔BL2012058〕
