摘要
目的系统评价大剂量盐酸氨溴索联合纤维支气管镜吸痰对老年重症肺炎血气指标及安全性的影响,为临床决策提供循证依据。方法采用计算机检索相关数据库,搜集从建库至2018年11月与本研究相关的临床研究,文献质量评价后,采用Revman 5.3软件进行Meta分析。结果共纳入相关文献14篇,Meta分析结果显示:与对照组相比,试验组血氧分压(Partial pressure of oxygen,PaO2)[SMD=0.75,95%CI(0.44,1.06),P<0.001]、血氧饱和度(Pulse Oxygen Saturation,SpO2)[SMD=1.20,95%CI(0.78,1.61),P<0.001]、氧合指数(Partial pressure of oxygen/Fraction of inspiration O2,PaO2/FiO2)[SMD=0.13,95%CI(0.81,1.45),P<0.001]均提高,差异具有统计学意义;多器官功能衰竭(Multiple organ failure,MOF)发生率[RR=0.69,95%CI(0.61,0.78),P<0.001]、28 d死亡率[RR=0.63,95%CI(0.54,0.74),P<0.001]均降低,差异具有统计学意义。结论对老年重症肺炎患者采用大剂量盐酸氨溴索联合纤维支气管镜治疗,能有效提高治疗效果,改善患者的血气指标,降低死亡率,该治疗方式具有较好的临床应用价值。
OBJECTIVE To systematically evaluate the effect of high-dose ambroxol hydrochloride combined with fiberoptic bronchoscopy on blood gas index and safety of severe pneumonia in elderly patients,so as to provide evidence for clinical decision.METHODS We searched the related database and collected the clinical research papers related to this study.The quality of the literature was evaluated and then Revman 5.3 software was used for meta-analysis.RESULTS A total of 14 literatures were included.The result indicated that,compared to the control group,the blood oxygen partial pressure[SMD=0.75,95%CI(0.44,1.06),P<0.001],oxygen saturation[SMD=1.20,95%CI(0.78,1.61),P<0.001]and oxygenation index[SMD=0.13,95%CI(0.81,1.45),P<0.001]in the experimental group were significantly increased[RR=0.69,95%CI(0.61,0.78),P<0.001],28 d mortality rate[RR=0.63,95%CI(0.54,0.74),P<0.001]were significantly lower.CONCLUSION The use of high-dose ambroxol hydrochloride combined with fiberoptic bronchoscopy in elderly patients with severe pneumonia can effectively improve the therapeutic effect,increase the value of the patient’s blood gas indices and reduce the mortality rate.This treatment method has good value for clinical application.
作者
张健
蔡江红
彭吾训
ZHANG Jian;CAI Jiang-hong;PENG Wu-xun(Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou 550009,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第23期3563-3568,共6页
Chinese Journal of Nosocomiology
基金
贵州省卫生计生委科学技术基金资助项目(gzwjkj2016-1-001)
贵阳市科技局基金资助项目(GY201603)
关键词
盐酸氨溴索
重症肺炎
纤维支气管镜
振动排痰
Ambroxol hydrochloride
Severe pneumonia
Fiberoptic bronchoscopy
Vibratory drainage
