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目的采用Meta分析方法综合评价俯卧位与仰卧位对急性肺损伤或急性呼吸窘迫综合征患者(ALI或ARDS)的作用效果。方法制定原始文献的纳入标准、排除标准及检索策略,检索多个中英文文摘型数据库及全文数据库,获得俯卧位辅助治疗ALI或ARDS的临床随机对照试验(RCT),进行文献质量评价后,采用RevMan4.2软件进行数据分析。结果共纳入4篇RCT研究,Meta分析结果显示,俯卧位较仰卧位具有较好的改善氧合指数(PaO2与FiO2)的作用,但在提高PaO2、降低二氧化碳分压(Pa-CO2)和病死率方面无统计学意义;除俯卧位压疮的发生率较高以外,两种体位在其他并发症方面无统计学意义。结论俯卧位具有改善ALI或ARDS患者PaO2与FiO2的作用,但对其他呼吸参数的改善情况,并发症情况及降低病死率方面的效果还需要大样本多中心RCT研究进一步验证。
Objective To evaluate the effect of prone-position and supine position on patients with acute lung injury or acute respiratory distress syndrome (ALI or ARDS) by Meta-analysis. Methods To establish the inclusion criteria, exclusion criteria and search strategies of the original documents, to search a number of Chinese-English digest databases and full-text databases to obtain clinical randomized controlled trials (RCTs) of adjuvant treatment of ALI or ARDS in prone position. After quality evaluation of the literature, RevMan4.2 software for data analysis. Results A total of 4 RCTs were included in the study. The results of Meta analysis showed that the prone position had a better oxygenation index (PaO2 vs FiO2) than the supine position. However, PaO2 and Pa2 + Rate was not statistically significant; except for the higher incidence of pressure ulcers in the prone position, the two positions were not statistically significant in other complications. Conclusions Prone position has the effect of improving PaO2 and FiO2 in patients with ALI or ARDS. However, the improvement of other respiratory parameters, complication and mortality reduction still need large sample multi-center RCT study to further verify.