摘要
目的 探讨经鼻高流量湿化氧疗在ICU患者撤机后的临床疗效.方法 计算机检索Cochrane图书馆,EMBASE、PubMed、Elsevier、中国期刊全文数据库、万方数据库和中国生物医学文献数据库,收集关于经鼻高流量湿化氧疗的临床随机对照试验（RCT）.由2名研究员按照纳入和排除标准筛选文献,评价纳入文献的质量并提取资料,使用RevMan5.3软件进行统计分析.结果 共纳入5篇RCT,982例研究对象.Meta分析结果显示,相比于传统吸氧方式,经鼻高流量湿化氧疗患者重插管率更低（OR=0.39,95% CI 0.25~0.62,P〈0.05）,氧合指数、舒适度、耐受性更优;而撤机后呼吸衰竭（OR=0.85,95% CI 0.35~2.09）、呼吸道感染（OR=0.69,95% CI 0.36~1.34）、ICU住院时间（MD=0.51,95% CI-0.02~1.03）、住院死亡率（OR=0.81,95% CI 0.39~1.69）等方面无明显优势（P〉0.05）.结论 ICU患者撤机后采用经鼻高流量湿化氧疗可降低ICU患者撤机后重插管率、提高氧合指数、舒适度和耐受性,但对降低ICU患者撤机后呼吸衰竭、呼吸道感染、ICU住院时间及死亡率无明显影响.
Objective To evaluate the clinical effects of heated humidified high flow nasal cannula oxygen therapy on post-extubation intensive care unit（ICU）patients. Methods A computerized search was performed through Cochrane Library,EMBASE,PubMed,Elsevier,CNKI,Wanfang Database, SinoMed for randomized controlled trial（RCTs） which studied the effects of clinical effects of heated humidified high flow nasal cannula oxygen therapy on post-extubation ICU patients. Two reviewers separately searched the articles, evaluated the quality of the literatures, extracted date according to the inclusion and exclusion criteria. RevMan5.3 was used for Meta-analysis. Results Five RCTs were included involving 982 patients in the study. The Results of meta-analysis showed that the HFNC group was lower than COT group on the re-intubation rate （OR=0.39, 95% CI 0.25-0.62, P〈0.05）. About oxygenation index, comfort level and toleration of patients, HFNC group was superior to the COT group. Two groups had no significant differences（P〉0.05）on post-extubation respiratory failure（OR=0.85,95% CI 0.35-2.09）,respiratory infection（OR=0.69,95% CI 0.36-1.34）,hospital length of stay（MD=0.51,95%CI-0.02-1.03）, mortality of hospital （OR=0.81,95% CI 0.39-1.69）. Conclusions The use of HFNC oxygen therapy can reduce there-intubation rate,improve oxygenation index,comfort level and tolerance on post-extubation ICU patients, while HFNC group has no significant impact on the post-extubation respiratory failure, respiratory infection, hospital length of stay, mortality of hospital compared with COTgroup. However, in view of the quantity and quality of study. More RCTs should be conducted to verify the results.
出处
《中国实用护理杂志》
2017年第33期2630-2635,共6页
Chinese Journal of Practical Nursing
关键词
并发症
META分析
经鼻高流量湿化氧疗
撤机后
Complication
Meta-analysis
Heated humidified high flow nasal cannula oxygen therapy
Post-extubation
