头罩与面罩无创通气对慢性阻塞性肺疾病患者临床有效性及安全性的Meta分析

目的 比较头罩与面罩无创通气对慢性阻塞性肺疾病(COPD)患者临床治疗的有效性及安全性。方法 检索PubMed、Web of Science、中国知网(CNKI)、万方、维普数据库中针对头罩与面罩无创通气治疗COPD患者的相关研究,应用Review Manager 5.3统计软件进行Meta分析。结果 共纳入文献9篇,共606例患者,包括头罩组304例,面罩组302例。Meta分析结果显示,头罩无创通气与面罩式无创通气对于降低患者呼吸频率、提高氧合指数、降低二氧化碳分压方面差异无统计学意义,对于年龄≤70岁的患者,头罩式可降低患者呼吸频率(P<0.05),提高氧合指数(P<0.05)。头罩无创通气可显著减少面部皮肤溃疡或坏死、结膜炎、不耐受、漏气等并发症发生率,差异具有统计学意义(P<0.05)。结论 头罩式无创通气治疗COPD患者较面罩式可显著减少临床并发症,尤其在对于年龄≤70岁的患者中治疗有效性及安全性更高,可提高患者氧合指数并降低呼吸频率,更具临床优势。

Meta-analysis of the efficacy and safety of helmet and face mask noninvasive ventilation in patients with chronic obstructive pulmonary disease

Objective To compare the efficacy and safety of helmet and face mask noninvasive ventilation in clinical treatment of patients with chronic obstructive pulmonary disease (COPD).Methods Retrieval related studies were carried out of COPD patients treated with helmet and face mask noninvasive ventilation in PubMed, Web of Science, CNKI, Wanfang and Weip database and Review Manager 5.3 statistical software was used for meta analysis. Results Nine articles were selected with 606 patients including 304 cases in the helmet group and 302 cases in the face mask group. Meta analysis showed that there was no significant difference between helmet and face mask noninvasive ventilation in reducing respiratory frequency, increasing oxygen and index, and reducing partial pressure of carbon dioxide. For patients of 70 years old and below, helmet could decrease respiratory frequency (P<0.05) and increase oxygenation index (P<0.05). Helmet noninvasive ventilation could reduce the incidence of complications such as facial skin ulcers or necrosis, conjunctivitis, intolerance and air leakage, and the difference was statistically significant (P<0.05).Conclusion Compared with face mask noninvasive ventilation, helmet noninvasive ventilation can significantly reduce clinical complications in COPD patients. Especially in patients of 70 years old and below, it can improve the oxygenation index and reduce respiratory frequency, having higher efficacy and safety.