摘要
目的 系统评价国内沐舒坦与α-糜蛋白酶的气管湿化效果,以更好地指导临床护士人工气管湿化液的选择.方法 系统检索中国生物医学文献数据库(CBM)、中国学术期刊网络出版总库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库建库至2015年11月收录的文献资料,中文检索词:“菼清、盐酸氨溴索葡萄糖注射液、盐酸氨溴索、α-糜蛋白酶、沐舒坦、湿化”,依据Cochrane协作网随机对照试验(RCT)质量评价标准评价纳入研究质量,应用RevMan 5.3分析软件对所提取的数据进行敏感性和异质性分析,并采用固定效应或随机效应模型计算合并后的综合效应.结果 纳入9个RCT,人工气管患者624例,所纳入文献的研究质量一般;meta分析相对危险度(RR)值,合并肺部感染[RR =0.32,95％ CI(0.23 ～0.44)]、气管黏膜出血[RR =0.48,95％ CI(0.34～0.68)]、刺激性咳嗽[RR =0.40,95％ CI(0.29 ～0.56)]及痰痂形成[RR =0.32,95％ CI(0.22～0.46)],沐舒坦持续气管内湿化组与α-糜蛋白酶持续湿化间差异有统计学意义(P＜0.05).结论 沐舒坦用于气管湿化可以减少肺部感染、气管黏膜出血、刺激性咳嗽和痰痂形成的发生,其气管湿化效果优于α-糜蛋白酶气管湿化法.
Objective To systematically evaluate the effects of ambroxol and ot-chymotrypsin on artificial airway humidification in China,and to choose the optimal airway humidifying fluid for clinical nursing.Methods All related literatures included in the databases of CBM,CNKI,VIP,Wanfang up to Nov 2015 were retrieved with the following search terms:ambroxol,mucosolvan,α-chymotrypsin,and humidification.The study quality of selected literatures was evaluated by the Cochrane evaluation handbook of randomized controlled trials (RCTs).And by the software of RevMan 5.3,their sensitivity and heterogeneity were analyzed and the cumulative effects after combination were calculated through fixed or random effect models.Results Totally,9 RCTs were selected with 624 patients involved,and in most trials the study quality was general.The results of mcta-analysis showed the merged relative risk (RR) values and their 95％ CI for pulmonary infection,airway mucosal bleeding,irritative cough and sputum scab formation were as follows:0.32 (0.23 ～ 0.44),0.48 (0.34 ～ 0.68),0.40 (0.29 ～ 0.56) and 0.32 (0.22 ～ 0.46).There were statistically significant differences in the continuous airway humidification between the ambroxol and α-chymotrypsin groups (P ＜ 0.05).Conclusion Application of ambroxol in the airway humidification could decrease the incidence of pulmonary infections,airway mucosal bleeding,irritative cough and sputum scab formation,and its effect would be superior to the α-chymotrypsin.
出处
《安徽医学》
2016年第11期-,共4页
Anhui Medical Journal
