摘要
目的评价每日唤醒镇静对危重症机械通气患者预后的影响。方法计算机检索Cochrane Library、Pubmed、Ovid、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数据库中有关每日唤醒的随机对照试验,由2名研究者按照纳入和排除标准筛选文献,对文献质量进行严格评价并提取资料,对符合质量标准的研究使用Revman 5.3软件进行meta分析。结果共纳入14个随机对照试验,共1 923例患者。Meta分析结果表明:每日唤醒镇静能降低危重症机械通气患者死亡率[RR0.77,95%CI(0.65,0.92),P=0.003]和减少呼吸机相关肺炎的发生[RR0.38,95%CI(0.25,0.56),P<0.00001],而且能提高撤机的成功率[RR1.46,95%CI(1.18,1.82),P=0.0006]。结论每日唤醒镇静能降低危重症机械通气镇静患者的死亡率和呼吸机相关性肺炎的发生率,提高撤机成功率。
Objective To evaluate the effect of prognosis by daily interruption of sedation（DIS） for critically ill patient with mechanical ventilation. Method The relevant randomized controlled trials were searched in the Cochrane Library,Pubmed,Ovid,CNKI, VIP and WanFang databases. Experimental group received DIS and the control group received continuous sedation . Two reviewers selected studies according to the inclusion and exclusion criteria, the quality of studies was critically appraised,and data were extracted by two reviewers independently. Meta-analysis was conducted by using RevMan 5.3. Result Fourteen randomized controlled trials met the inclusion criteria and enrolled 1923 patients. According to the meta analysis,DIS reduced the mortality [RR 0.77,95%CI （0. 65,0. 92） ,P= 0. 003] and the incidence of ventilator-associated pneumonia [RR0. 38,95 % CI（0. 25,0.56）, P〈0. 00001] , then increase the rate of remove the ventilator successfully [RR 1.46,95 % CI（1.18,1.82）, P = 0. 00061. Conclusion DIS appears effective in reducing the mortality and preventing ventilator-associated pneumonia on critically ill patients with mechanical ventilation, and improve the rate of remove the ventilator successfully.
出处
《护士进修杂志》
2015年第24期2217-2220,共4页
Journal of Nurses Training
关键词
每日唤醒镇静
危重症
机械通气
呼吸机相关性肺炎
META分析
Daily interruption of sedation
Critically ill patients
Mechanical ventilation
Ventilaton-associated pneumonia
Meta-analysis
