摘要
目的评价加温湿化高流量鼻塞通气（heated humidified high-flow nasal cannula, HHHFNC）初始治疗轻-中度新生儿呼吸窘迫综合征（respiratory distress syndrome, RDS）的有效性。方法检索PubMed、EMBASE、Cochrane图书馆、中国期刊全文数据库、万方数据库、维普中文科技期刊数据库及中国生物医学文献数据库，查找所有HHHFNC和/或经鼻持续气道正压通气（nasal continuous positive airway pressure, nCPAP）治疗RDS的随机对照试验文献。采用Review Manager5.2软件进行meta分析。分别比较RDS早产儿中，HHHFNC组和nCPAP组在初始治疗失败、出院前死亡率、鼻腔损伤、支气管肺发育不良（bronchopulmonary dysplasia，BPD），以及动脉导管未闭（patent ductus arteriosus，PDA）等发生率的差异。结果共纳入8篇随机对照研究，包括了1 400例合并RDS的早产患儿。与nCPAP组相比，HHHFNC组患儿初始呼吸支持失败的比例差异无统计学意义（RR=1.22，95%CI：0.94~1.59，P=0.13）；鼻腔损伤的发生率明显降低（RR=0.35，95%CI：0.24~0.52，P〈0.001）。HHHFNC组与nCPAP组的患儿出院前病死率、BPD、PDA及气漏发生率差异均无统计学意义（P值均〉0.05）。结论HHHFNC初始治疗胎龄≥28周早产儿合并轻-中度RDS是一种有效的呼吸支持方法。
ObjectiveTo investigate the efficacy of heated humidified high-flow nasal cannula （HHHFNC） as the primary means of respiratory support for preterm infants with mild or moderate respiratory distress syndrome （RDS）.MethodsRandomized controlled trials （RCTs） about HHHFNC and/or nasal continuous positive airway pressure （nCPAP） in preterm infants with RDS were searched in PubMed, EMBASE, Cochrane library, Chinese Journal Full-text Database （CJFD）, Wanfang Data base, VIP Database and China Biology Medicine disc （CBM）. Meta-analysis was conducted with Review Manager 5.2 software to compare HHHFNC and CPAP groups in the outcomes of preterm infants with RDS, which included initial support failure, nasal trauma, pre-discharge mortality and incidences of bronchopulmonary dysplasia （BPD） and patent ductus arteriosus （PDA） before discharge.ResultsEight randomized trials, including 1 400 preterm infants with RDS were included. Results of the meta-analysis demonstrated that no significant difference in the percentage of initial support failure was observed between the two groups （RR=1.22, 95%CI： 0.94-1.59, P=0.13）, and HHHFNC was associated with decreased risk for nasal trauma （RR=0.35, 95%CI： 0.24-0.52, P〈0.001）. There was no significant difference in the incidence of death, BPD, PDA or gas leaking before discharge between the two groups.ConclusionsHHHFNC is an efficient respiratory support for preterm infants （gestational age over 28 weeks） with mild or moderate RDS.
出处
《中华围产医学杂志》
CAS
CSCD
2017年第11期818-823,共6页
Chinese Journal of Perinatal Medicine
关键词
呼吸窘迫综合征
新生儿
连续气道正压通气
热温度
湿度
无创通气
META分析
Respiratory distress syndrome, newborn
Continuous positive airway pressure
Hottemperature
Humidity
Noninvasive ventilation
Meta-analysis
