摘要
目的探索个体化呼气末正压(PEEP)对全麻手术患者术后肺功能的影响。方法检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、维普、万方数据库,收集个体化PEEP对全麻手术患者术后肺功能影响的随机对照试验(RCT),检索时间为建库至2021年6月。按照Cochrane指导手册进行文献筛选、资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果共纳入RCT研究17篇,共计患者1355例,其中个体化PEEP组670例,固定PEEP组685例。与固定PEEP组比较,个体化PEEP组术后肺部并发症发生率明显降低(RR=0.60,95%CI 0.49~0.74,P<0.001),个体化PEEP组术中肺顺应性明显升高(SMD=1.41,95%CI 0.98~1.83,P<0.001),个体化PEEP组术后PaO_(2)/FiO_(2)明显升高(SMD=1.02,95%CI 0.61~1.43,P<0.001)。结论个体化PEEP可提高术中肺顺应性、改善术后氧合,降低全麻手术患者术后肺部并发症发生率。
Objective To explore the effect of individualized positive end-expiratory pressure(PEEP)on postoperative pulmonary function of patients undergoing general anesthesia.Methods Randomized controlled trials(RCTs)about the effect of individualized PEEP in postoperative pulmonary function in patients undergoing general anesthesia were searched in the PubMed,Cochrane Library,Embase,Web of Science,CNKI,VIP,and Wangfang data from the the year of establishment to June 2021.After literature screening,data extraction and quality assessment were performed according to the Cochrane guidelines.RevMan 5.3 software was used for meta-analysis.Results Seventeen RCTs including 1355 patients were enrolled,670 patients in individualized PEEP group and 685 patients in fixed PEEP group.Compared with the fixed PEEP group,the incidence of postoperative pulmonary complications was significantly decreased in the individualized PEEP group(RR=0.60,95%CI 0.49-0.74,P<0.001),and intraoperative lung compliance was significantly increased in the individualized PEEP group(SMD=1.41,95%CI 0.98-1.83,P<0.001),and postoperative PaO_(2)/FiO_(2) was significantly increased in the individualized PEEP group(SMD=1.02,95%CI 0.61-1.43,P<0.001).Conclusion Individualized PEEP can significantly enhance intraoperative lung compliance,improve oxygenation and reduce the incidence of postoperative pulmonary complications.
作者
翁丽波
陈小萍
葛亚丽
高巨
WENG Libo;CHEN Xiaoping;GE Yali;GAO Ju(Department of Anesthesiology,Northern Jiangsu People’s Hospital Affiliated to Yangzhou University,Yangzhou 225000,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2022年第8期846-850,共5页
Journal of Clinical Anesthesiology
关键词
个体化
呼气末正压
肺保护通气策略
META分析
Individualized
Positive end-expiratory pressure
Lung protective ventilation strategy
Meta analysis
