中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

不同吸氧方式对保守治疗自发性气胸疗效的 Meta 分析

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目的 运用 Meta 分析的方法比较两种不同吸氧方式[(吸氧时间<4 h/d;吸氧流量>6 L/min)VS(吸氧时间>4 h/d;吸氧流量<6 L/min]对于保守治疗自发性气胸患者的疗效差异。 方法 通过计算机检索 PubMed、The Cochrane Library、Web of Science、中国生物文献数据库(CBM)、万方数据库 (WANFANG) 和中国知网 (CNKI) 等数据库,查找关于两种不同流量吸氧方式[(吸氧时间<4 h/d;吸氧流量>6 L/min)VS(吸氧时间>4 h/d;吸氧流量<6 L/min)]下保守治疗的自发性气胸患者的随机对照试验(randomized controlled trial,RCT),检索时间截至 2017 年 12 月,由 2 位研究员依据制定的纳入与排除标准独立筛选文献、评价文献质量并提取资料,采用 RevMan5.3 软件进行分析。 结果 最终纳入 4 个 RCT,包括 226 例患者。Meta 分析结果显示:与吸氧时间>4 h/d、吸氧流量<6 L/min 的吸氧方式相比,吸氧时间<4 h/d、吸氧流量>6 L/min 的吸氧方式能更显著缩短吸氧 5 天后肺压缩程度[MD=–2.81,95%CI(–4.18,–1.44),P<0.05]、住院天数[MD=–3.26,95%CI(–6.05,–0.47),P<0.05]、肺复张时间[MD=–2.78,95%CI(–5.27,–0.28),P<0.05],但在吸氧 5 天后氧分压的对比方面无明显统计学差异[MD=10.68,95%CI(–7.03,28.39),P<0.05]。 结论 对于保守治疗的自发性气胸患者,吸氧时间<4 h/d、吸氧流量>6 L/min 的吸氧方式更能缩短吸氧 5 d 后肺压缩程度、住院天数、肺复张时间,该研究结果受到纳入 RCT 数量与质量的影响。

Objective To investigate the effects of two different oxygen therapy (oxygen time<4 h/d, oxygen flow>6 L/min versus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax by meta-analysis. Methods The following electronic databases as PubMed, The Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Wanfang Database and China National Knowledge Database were retrieved on computer for randomized controlled trials (RCTs) of comparing two different oxygen therapy [(oxygen time<4 h/d, oxygen flow>6 L/min versus oxygen time>4 h/d, oxygen flow<6 L/min)] on conservative treatment of spontaneous pneumothorax. The retrieval time was from inception to December 2017. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then data were analyzed by RevMan 5.3 software. Results A total of 4 RCTs involving 226 patients were included. The meta-analysis showed that compared with lower oxygenflow (oxygen time>4 h/d, Oxygen flow<6 L/min), the higher oxygenflow (oxygen time<4 h/d, Oxygen flow>6 L/min) could obviously shorten The degree of pulmonary compression after oxygen therapy for 5 days [MD=–2.81, 95%CI (–4.18, –1.44),P<0.05], during of hospital stay [MD=–3.26, 95%CI (–6.05, –0.47),P<0.05], during of recruitment maneuvers [MD=–2.78, 95%CI (–5.27, –0.28),P<0.05], but there was no significant difference in oxygen partial pressure after oxygen therapy for 5 days [MD=10.68, 95%CI (–7.03, 28.39),P=0.24]. Conclusion The higher oxygenflow (oxygen time<4 h/d, Oxygen flow>6 L/min) could obviously shorten the degree of pulmonary compression after oxygen therapy for 5 days、during of hospital stay and during of recruitment maneuvers, but the results were influenced by the number and quality of RCT.

关键词: 自发性气胸; 氧疗; Meta 分析; 随机对照试验

Key words: Spontaneity pneumothorax; Oxygen therapy; Meta-analysis; Randomized controlled trial

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