中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2014年
1期
48-54
,共7页
贺宏丽%胡淑玲%陈齐红%刘玲%黄英姿%杨毅%邱海波
賀宏麗%鬍淑玲%陳齊紅%劉玲%黃英姿%楊毅%邱海波
하굉려%호숙령%진제홍%류령%황영자%양의%구해파
硫糖铝%抗酸剂%胃肠出血%肺炎,呼吸机相关性%Meta分析
硫糖鋁%抗痠劑%胃腸齣血%肺炎,呼吸機相關性%Meta分析
류당려%항산제%위장출혈%폐염,호흡궤상관성%Meta분석
Sucralfate%Antacids%Gastrointestinal hemorrhage%Pneumonia,ventilator-associated%Meta-analysis
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.
目的 比較硫糖鋁和抑痠劑預防應激性潰瘍對ICU機械通氣患者髮生呼吸機相關性肺炎(VAP)的影響.方法 計算機檢索PubMed、EMbase、Cochrane Library、萬方數據庫、中國期刊全文數據庫和手工檢索從建庫至2013年3月硫糖鋁和抑痠劑預防ICU機械通氣患者應激性潰瘍的RCT研究,按Cochrane協作網推薦的繫統評價員手冊5.2.3文獻質量評價標準評價納入研究質量,用RevMan 5.2軟件進行Meta分析.結果 共納入15項RCT研究,總樣本量為2883例,硫糖鋁組1315例,抑痠劑組1568例.Meta分析結果顯示:硫糖鋁組較抑痠劑組能顯著降低VAP的髮生率(RR =0.81,95％ CI0.7～0.95,P=0.008),對上消化道齣血髮生率的影響差異無統計學意義(RR=0.96,95％ CI0.59 ～ 1.58,P=0.88),兩組患者機械通氣時間、ICU留治時間、ICU病死率均差異無統計學意義(P值均＞0.05).結論 應用硫糖鋁可降低ICU機械通氣患者VAP的髮生率,對消化道齣血的髮生率、機械通氣時間、ICU留治時間、ICU病死率無明顯影響.
목적 비교류당려화억산제예방응격성궤양대ICU궤계통기환자발생호흡궤상관성폐염(VAP)적영향.방법 계산궤검색PubMed、EMbase、Cochrane Library、만방수거고、중국기간전문수거고화수공검색종건고지2013년3월류당려화억산제예방ICU궤계통기환자응격성궤양적RCT연구,안Cochrane협작망추천적계통평개원수책5.2.3문헌질량평개표준평개납입연구질량,용RevMan 5.2연건진행Meta분석.결과 공납입15항RCT연구,총양본량위2883례,류당려조1315례,억산제조1568례.Meta분석결과현시:류당려조교억산제조능현저강저VAP적발생솔(RR =0.81,95％ CI0.7～0.95,P=0.008),대상소화도출혈발생솔적영향차이무통계학의의(RR=0.96,95％ CI0.59 ～ 1.58,P=0.88),량조환자궤계통기시간、ICU류치시간、ICU병사솔균차이무통계학의의(P치균＞0.05).결론 응용류당려가강저ICU궤계통기환자VAP적발생솔,대소화도출혈적발생솔、궤계통기시간、ICU류치시간、ICU병사솔무명현영향.
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.
