摘要
[目的]系统评价家庭无创正压机械通气在慢性阻塞性肺疾病(COPD)及其合并呼吸衰竭病人中的应用效果。[方法]计算机检索万方数据库、中国知网、中国生物医学文献数据库、PubMed、Cochrane Library、Web of science数据库,检索时间均从建库至2017年1月,搜集有关家庭无创正压机械通气应用于COPD及COPD合并呼吸衰竭病人的随机对照试验,采用RevMan 5.3软件进行Meta分析。[结果]共纳入21项随机对照试验,共1 437例病人。Meta分析结果显示:家庭无创正压机械通气可以提高病人的动脉血氧分压[MD=8.47,95%CI(7.19,9.76),P<0.000 01]和一秒用力呼气容积[MD=0.09,95%CI(0.08,0.10),P<0.000 01],降低病人动脉血二氧化碳分压[MD=-9.01,95%CI(-10.25,-7.77),P<0.000 01],减少病人年住院次数[MD=-2.44,95%CI(-2.93,-1.95),P<0.000 01]及住院费用[MD=-0.39,95%CI(-0.62,-0.15),P=0.001]。[结论]现有证据表明,家庭无创正压机械通气可以有效改善COPD及COPD合并呼吸衰竭病人缺氧状况,促进病人康复,减轻病人经济负担。但受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。
Objective：To evaluate the application effect of family non-invasive positive pressure ventilation for patients with chronic obstructive pulmonary disease and its combined with respiratory failure.Method：Databases including Wanfang Data,CNKI,CBM,PubMed,Cochrane Library,Web of Science were searched electronically from inception to January 2017 to collect the randomized controlled trials（RCTs）about family non-invasive positive pressure ventilation for patients with COPD and its combined with respiratory failure.Meta analysis was performed using RevMan 5.3 software.Results：A total of 21 RCTs were included involving 1 437 cases.Meta analysis showed that family non-invasive positive pressure ventilation could improve arterial oxygen partial pressure[MD=8.47,95%CI（7.19,9.76）,P〈0.000 01]and one second forced expiratory volume[MD=0.09,95%CI（0.08,0.10）,P〈0.000 01],reduce arterial partial pressure of carbon dioxide[MD=-9.01,95%CI（-10.25,-7.77）,P〈0.000 01],number of annual hospitalization[MD=-2.44,95%CI（-2.93,-1.95）,P〈0.000 01]and hospitalization expenses[MD=-0.39,95%CI（-0.62,-0.15）,P=0.001].Conclusion：Present evidences showed that family non-invasive positive pressure ventilation could improve condition of hypoxia,promote the rehabilitation and reduce the economic burden of the patients.But it was limited by the quality and quantity of included researches so it needs to be verified by the high quality researches.
作者
金静
张彩云
张志刚
田金徽
侯宇颖
郭德姣
何金杰
Jin Jing;Zhang Caiyun;Zhang Zhigang(The First Hospital of Lanzhou University,Gansu 730000 Chin)
出处
《循证护理》
2018年第4期297-309,共13页
Chinese Evidence-Based Nursing
关键词
家庭无创正压机械通气
慢性阻塞性肺疾病
呼吸衰竭
META分析
随机对照试验
系统评价
疗效
family non-invasive positive pressure ventilation
chronic obstructive pulmonary disease
respiratoryfailure
Meta-analysis
randomized controlled trial
systematic evaluation ~ curative effect
