高频振荡通气治疗新生儿肺透明膜病文献的Meta分析

目的　综合比较高频振荡通气 (HFOV)与传统机械通气 (CMV)对新生儿肺透明膜病的治疗作用及其潜在危害性。方法　通过数据库检索出符合纳入分析条件的相关文献 12篇 ,采用Meta分析方法进行定性、定量综合分析 ,得出合并OR值及其 95 %可信区间。结果　与CMV相比 ,HFOV能明显改善肺透明膜病患儿的呼吸功能 (P <0 0 0 5 )以及降低慢性肺部疾病的发生率 (P <0 0 1) ,但增加新生儿颅内出血的危险性 (P <0 0 5 ) ;在两种通气方式引起的气漏方面 ,无明显差异 (P >0 0 5 )。结论　应用HFOV治疗新生儿肺透明膜病的效果优于CMV ,并可减少慢性肺部疾病的发生 ,但应注意其它并发症的出现。

A Meta-analysis of literature:high frequency oscillatory ventilation in the treatment of neonatal hyaline membrane disease

Objective To comprehensively compare the therapeutic effect and complications of high frequency oscillatory ventilation (HFOV) with conventional mechanical ventilation (CMV) in neonates with hyaline membrane disease(HMD).Methods Meta analysis was used to qualitatively and quantitatively evaluate the data extracted from 12 public papers,and combined Odds ratio(OR)and its 95% confidence interval were calculated.Results In comparison with CMV,HFOV could significantly improve the pulmonary function (P<0.005)and decrease the incidence of chronic lung disease (CLD)(P<0.01),but increase the possibility of intracranial hemorrhage (ICH)(P<0.05)in neonates with HMD.There was no significant difference between the incidence of air leak induced by HFOV and MCV(P>0.05).Conclusion HFOV is more beneficial than CMV in the therapeutic effect of neonatal HMD,and can significantly reduce CLD occurrence.More attention should be paid to the main complications when HFOV is applied to treat neonatal HMD