摘要
目的 比较硫糖铝和抑酸剂预防应激性溃疡对ICU机械通气患者发生呼吸机相关性肺炎（VAP）的影响.方法 计算机检索PubMed、EMbase、Cochrane Library、万方数据库、中国期刊全文数据库和手工检索从建库至2013年3月硫糖铝和抑酸剂预防ICU机械通气患者应激性溃疡的RCT研究,按Cochrane协作网推荐的系统评价员手册5.2.3文献质量评价标准评价纳入研究质量,用RevMan 5.2软件进行Meta分析.结果 共纳入15项RCT研究,总样本量为2883例,硫糖铝组1315例,抑酸剂组1568例.Meta分析结果显示：硫糖铝组较抑酸剂组能显著降低VAP的发生率（RR =0.81,95％ CI0.7～0.95,P=0.008）,对上消化道出血发生率的影响差异无统计学意义（RR=0.96,95％ CI0.59 ～ 1.58,P=0.88）,两组患者机械通气时间、ICU留治时间、ICU病死率均差异无统计学意义（P值均＞0.05）.结论 应用硫糖铝可降低ICU机械通气患者VAP的发生率,对消化道出血的发生率、机械通气时间、ICU留治时间、ICU病死率无明显影响.
Objective To evaluate the effect of sucralfate and acid-suppressive drugs on preventing ventilator-associated pneumonia （VAP） in mechanically ventilated patients.Methods All randomized controlled trials （RCTs）,which studied the effect of sucralfate and acid-suppressive drugs on the incidence of VAP in mechanically ventilated patients,were searched from PubMed,Embase and the Cochrane Library during January 1966 to March 2013 via manual and computer retrieval.All related data were extracted.Meta analysis was conducted using the statistical software RevMan 5.2 and the quality of the RCTs was strictly evaluated with the methods recommended by the Cochrane Collaboration.Results A total of 15 RCTs involving 1315 patients in the sucralfate group and 1568 patients in the acid-suppressive drug group were included in this study.The incidence of VAP was significantly reduced in the sucralfate group （RR =0.81,95% CI 0.7-0.95,P =0.008）,while no difference was found between the two groups in the incidence of stress-related gastrointestinal bleeding （RR =0.96,95% CI 0.59-1.58,P =0.88）.No statistical difference was found in the days on ventilator,duration of ICU stay and ICU mortality in the two groups （all P values 〉 0.05）.Conclusion In patients with mechanical ventilation,sucralfate could decrease the incidence of VAP,while has no such effect on the stress-related gastrointestinal bleeding,the days on ventilator,duration of ICU stay and ICU mortality.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2014年第1期48-54,共7页
Chinese Journal of Internal Medicine
基金
国家自然科学基金（81070049,81170057,81000828）
江苏省普通高校研究生科研创新计划项目（CXLX_0151）
关键词
硫糖铝
抗酸剂
胃肠出血
肺炎
呼吸机相关性
META分析
Sucralfate
Antacids
Gastrointestinal hemorrhage
Pneumonia, ventilator-associated
Meta-analysis
