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华西医学  2014 

选择性口咽腔脱污染对呼吸机相关性肺炎预防作用的系统评价

DOI: 10.7507/1002-0179.20140563, PP. 1849-1854

Keywords: 呼吸机相关性肺炎,口咽腔脱污染,系统评价,Meta分析

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Abstract:

目的 系统评价选择性口咽腔脱污染(SOD)能否预防呼吸机相关性肺炎(VAP)的发生。方法 计算机检索PubMed、EMbase、中国生物医学文献数据库、万方数据库、中国期刊全文数据库和Cochrane图书馆临床对照试验资料库,检索时间均从建库至2013年9月,对入选研究的参考文献进行手工检索。根据纳入和排除标准筛选文献、提取资料和进行质量评价,并用RevMan5.1软件进行Meta分析。结果 最终纳入10个随机对照试验,共2791例患者。Meta分析结果显示与对照组相比,SOD可减少VAP的发生RR=0.53,95%CI(0.43,0.65),P<0.00001,但全因病死率、重症监护病房住院时间及机械通气时间差异无统计学意义(P>0.05)。纳入研究均未见SOD相关的严重不良反应的发生。结论 SOD可安全有效地降低VAP的发生,其操作简便,对于需要机械通气的患者,若条件允许可作为VAP预防措施之一及早应用。

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