国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2013年
5期
352-357
,共6页
涂学平%王念%肖锦秀%胡克
塗學平%王唸%肖錦秀%鬍剋
도학평%왕념%초금수%호극
双水平气道正压通气%重叠综合征%呼吸衰竭
雙水平氣道正壓通氣%重疊綜閤徵%呼吸衰竭
쌍수평기도정압통기%중첩종합정%호흡쇠갈
Bilevel positive airway pressure ventilation%Overlap syndrome%Respiratory failure
目的 评价经口/鼻面罩双水平气道正压通气(bilevel positive airway pressure ventilation,BiPAP)对重叠综合征(overlap syndrome,OS)并发呼吸衰竭患者的治疗作用.方法 计算机检索PubMed、Medline、万方数据库、中国知网和维普数据库中关于BiPAP治疗OS患者并发呼吸衰竭的随机对照研究,检索时限为建库至2012年6月,同时追索有用的参考文献.并对相关数据进行分析,统计学分析采用Review Manager 5软件进行.结果 共纳入6个随机对照试验(randomized controlled trial,RCT),273例患者.Meta分析2个主要结局的结果显示:BiPAP联合临床常规治疗对OS患者并发呼吸衰竭的PaO2及PaCO2的影响与单纯临床常规治疗比较,其中6项研究中BiPAP联合临床常规治疗组与常规治疗组治疗后的PaO2差异有统计学意义[WMD=19.75,95％ CI (18.43,21.07)],5项研究中的两组治疗后的PaCO2差异有统计学意义[WMD=-12.13,95％ CI(-13.72,-i0.54)].结论 研究显示,BiPAP联合临床常规治疗可以明显改善OS患者并发呼吸衰竭的PaO2及PaCO2,临床医师可以将BiPAP联合临床常规治疗作为推荐.但鉴于纳入的研究较少,样本量小,且鉴于呼吸机治疗研究的研究性质及伦理道德问题,故难于做到双盲,研究的方法学质量不高,故仍需开展大样本、多中心、方法规范和科学的高质量RCT,以求进一步验证BiPAP加临床常规治疗对OS患者并发呼吸衰竭的疗效.
目的 評價經口/鼻麵罩雙水平氣道正壓通氣(bilevel positive airway pressure ventilation,BiPAP)對重疊綜閤徵(overlap syndrome,OS)併髮呼吸衰竭患者的治療作用.方法 計算機檢索PubMed、Medline、萬方數據庫、中國知網和維普數據庫中關于BiPAP治療OS患者併髮呼吸衰竭的隨機對照研究,檢索時限為建庫至2012年6月,同時追索有用的參攷文獻.併對相關數據進行分析,統計學分析採用Review Manager 5軟件進行.結果 共納入6箇隨機對照試驗(randomized controlled trial,RCT),273例患者.Meta分析2箇主要結跼的結果顯示:BiPAP聯閤臨床常規治療對OS患者併髮呼吸衰竭的PaO2及PaCO2的影響與單純臨床常規治療比較,其中6項研究中BiPAP聯閤臨床常規治療組與常規治療組治療後的PaO2差異有統計學意義[WMD=19.75,95％ CI (18.43,21.07)],5項研究中的兩組治療後的PaCO2差異有統計學意義[WMD=-12.13,95％ CI(-13.72,-i0.54)].結論 研究顯示,BiPAP聯閤臨床常規治療可以明顯改善OS患者併髮呼吸衰竭的PaO2及PaCO2,臨床醫師可以將BiPAP聯閤臨床常規治療作為推薦.但鑒于納入的研究較少,樣本量小,且鑒于呼吸機治療研究的研究性質及倫理道德問題,故難于做到雙盲,研究的方法學質量不高,故仍需開展大樣本、多中心、方法規範和科學的高質量RCT,以求進一步驗證BiPAP加臨床常規治療對OS患者併髮呼吸衰竭的療效.
목적 평개경구/비면조쌍수평기도정압통기(bilevel positive airway pressure ventilation,BiPAP)대중첩종합정(overlap syndrome,OS)병발호흡쇠갈환자적치료작용.방법 계산궤검색PubMed、Medline、만방수거고、중국지망화유보수거고중관우BiPAP치료OS환자병발호흡쇠갈적수궤대조연구,검색시한위건고지2012년6월,동시추색유용적삼고문헌.병대상관수거진행분석,통계학분석채용Review Manager 5연건진행.결과 공납입6개수궤대조시험(randomized controlled trial,RCT),273례환자.Meta분석2개주요결국적결과현시:BiPAP연합림상상규치료대OS환자병발호흡쇠갈적PaO2급PaCO2적영향여단순림상상규치료비교,기중6항연구중BiPAP연합림상상규치료조여상규치료조치료후적PaO2차이유통계학의의[WMD=19.75,95％ CI (18.43,21.07)],5항연구중적량조치료후적PaCO2차이유통계학의의[WMD=-12.13,95％ CI(-13.72,-i0.54)].결론 연구현시,BiPAP연합림상상규치료가이명현개선OS환자병발호흡쇠갈적PaO2급PaCO2,림상의사가이장BiPAP연합림상상규치료작위추천.단감우납입적연구교소,양본량소,차감우호흡궤치료연구적연구성질급윤리도덕문제,고난우주도쌍맹,연구적방법학질량불고,고잉수개전대양본、다중심、방법규범화과학적고질량RCT,이구진일보험증BiPAP가림상상규치료대OS환자병발호흡쇠갈적료효.
Objective To evaluate the therapeutic effect of bilevel positive airway pressure ventilation (BiPAP) on overlap syndrome (OS) complicated with respiratory failure.Methods PubMed,Medline,Wanfang Data,CNKI and VIP were searched for the randomized controlled trials (RCT) of the therapeutic effect of BiPAP on overlap syndrome complicated with respiratory failure from the date of establishment of the databases to June 2012.The bibliographies of the in-cluded studies were searched too.The extracted data were analyzed by Review Manager 5.Results A total 6 trials(273 patients) were discovered.Meta-analyses showed that standard therapy plus BiPAP,compared with standard therapy alone,can improve PaO2 and PaCO2 (WMD =19.75,95％ CI 18.43 to 21.07 and WMD ＝-12.13,95％ CI-13.72 to-10.54,respectively).Conclusions The evidence shows standard therapy plus BiPAP can improve PaO2 and PaCO2 of overlap synd-rome complicated with respiratory failure.The clinicians should recommend it.Because of the limitations of the included studies,more large-sample and high-quality RCT are required.
