摘要
目的用荟萃分析的方法探讨持续侧方旋转治疗（CLRT）预防呼吸机相关性肺炎（VAP）的效果。方法主要检索Medline及中国生物医学文献服务系统两个数据库,纳入随机对照临床研究,其中干预组予以CLRT治疗,对照组予以传统治疗。从每项研究中提取相关数据,包括研究人群、纳入与排除标准、VAP诊断标准、VAP发生率、ICU病死率、机械通气时间和ICU住院时间。VAP发生率及病死率作为二分类变量提取,机械通气时间和ICU住院时间作为连续变量提取。用ReviewManager5.0系统分析VAP的发生率、病死率及其95%CI,临床异质性采用I2统计量检验。结果共有5项研究符合纳入标准。CLRT治疗能显著降低VAP发生率（OR=0.50,95%CI0.32~0.78）,且临床异质性检验无显著性。CLRT治疗不能减少患者ICU病死率,对机械通气时间和ICU住院时间也无显著影响。结论目前的研究支持CLRT治疗能显著降低VAP的发生率,但对于ICU病死率、机械通气时间和ICU住院时间的影响需更多的研究加以探讨。
Objective To explore the efficacy of continuous lateral rotation therapy （CLRT） for the prevention of ventilator associated pneumonia （VAP）. Methods Database of Medline and SinoMed were searched. Randomized and controlled trials assessing the efficacy of CLRT vs. placebo or conventional treatment for the prevention of VAP were included. Data were extracted on study population, exclusion and inclusion criteria, diagnostic criteria of VAP, incidence of VAP, ICU mortality, ICU length of stay, and duration of mechanical ventilation. The VAP incidence and mortality were extracted as dichotomous variables and the other parameters were extracted as continuous variables. The pooled analyses of VAP incidence and mortality were performed by using Review Manager 5.0 software. The heterogeneity was analyzed by the statistic 12. Results A total of 5 clinical trials met the inclusion criteria. CLRT could reduce the incidence of VAP （ OR = 0. 50,95 % CI 0. 32-0. 78 ） , and the heterogeneity was not statistically significant. The impact of CLRT on the ICU mortality was insignificant. The ICU length of stay and duration of mechanical ventilation were not significantly different between CLRT and control groups. Conclusion CLRT is beneficial for the prevention of VAP,whereas its impacts on other clinical outcomes such as the ICU mortality,ICU length of stay, and duration of mechanical ventilation require further investigations.
出处
《中国呼吸与危重监护杂志》
CAS
2010年第6期570-574,共5页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
持续侧方旋转治疗
呼吸机相关性肺炎
荟萃分析
Continuous lateral rotation therapy
Ventilator associated pneumonia
Meta-analysis
