[1]林茜,白永琪,李晓琴,等.5岁以下呼吸系统疾病患儿高流量鼻导管氧疗有效性和安全性的贝叶斯Meta分析[J].军事护理,2021,38(07):10-15.[doi:10.3969/j.issn.1008-9993.2021.07.003]
　LIN Xi,BAI Yongqi,LI Xiaoqin,et al.Efficacy and Safety of High-Flow Nasal Cannula Oxygen Therapy in Children under Five Years Old: A Meta-Analysis[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(07):10-15.[doi:10.3969/j.issn.1008-9993.2021.07.003]
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5岁以下呼吸系统疾病患儿高流量鼻导管氧疗有效性和安全性的贝叶斯Meta分析
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《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
38
期数:
2021年07期
页码:
10-15
栏目:
证据整合专栏
出版日期:
2021-07-15

文章信息/Info

Title:
Efficacy and Safety of High-Flow Nasal Cannula Oxygen Therapy in Children under Five Years Old: A Meta-Analysis
文章编号:
1008-9993(2021)07-0010-06
作者:
林茜; 白永琪; 李晓琴; 刘勤
(西南医科大学附属医院 儿科,四川 泸州 646000)
Author(s):
LIN Xi; BAI Yongqi; LI Xiaoqin; LIU Qin
(Department of Pediatrics,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)
关键词:
高流量鼻导管氧疗;  常规氧疗;  经鼻持续气道正压通气;  呼吸系统疾病患儿;  Meta 分析
Keywords:
high-flow nasal cannula;  conventional oxygen therapy;  nasal continuous positive airway pressure;  with respiratory diseases;  Meta-analysis
分类号:
R47
DOI:
10.3969/j.issn.1008-9993.2021.07.003
文献标志码:
A
摘要:
目的 系统评价5岁以下呼吸系数疾病患儿使用高流量鼻导管氧疗(high-flow nasal cannula,HFNC)的有效性和安全性。方法 计算机检索PubMed、Embase、The Cochrane Library、中国生物医学文献服务系统、万方数据库、中国知网和维普期刊数据库已发表的关于5岁以下呼吸系数疾病患儿使用HFNC的随机对照试验(randomized controlled trials,RCT),进行Meta分析。结果 纳入2015-2020年发表的RCT文献11篇,共2466例患儿。Meta分析结果显示,在<5岁肺炎伴轻度低氧血症、轻中度毛细支气管炎的患儿中,与常规氧疗比较,HFNC可以显著降低患儿治疗失败率(P<0.001); 在<5岁重症肺炎伴呼吸衰竭、重度毛细支气管炎的患儿中,与经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)比较,鼻损伤发生率降低(P=0.004),但HFNC治疗失败率增加(P=0.032); 分别与常规氧疗和nCPAP比较,HFNC对患儿插管率、住院病死率、气漏综合征发生率、总住院时间、ICU住院时间及用氧时间差异均无统计学意义(均P>0.05)。结论 基于现有临床证据,HFNC可作为<5岁肺炎伴轻度低氧血症、轻中度毛细支气管炎患儿的呼吸支持措施,不建议在<5岁重症肺炎伴呼吸衰竭、重度毛细支气管炎的患儿中使用HFNC。
Abstract:
Objective To systematically evaluate the efficacy and safety of high-flow nasal cannula(HFNC)in children with respiratory diseases under five years old.Methods The database of PubMed,EMBASE,the Cochrane Library,China biomedical database,Wanfang,CNKI and VIP database were searched for the published random controlled trials(RCT)related to children with respiratory diseases under 5 years old using HFNC,then the Meta analysis was performed.Results A total of 2466 children were included from 11 RCT studies which published from 2015 to 2020.Compared with conventional oxygen therapy,HFNC could significantly reduce the treatment failure rate of children under five years with pneumonia,mild hypoxemia and mild to moderate bronchiolitis(P<0.001).Compared with nasal continuous positive airway pressure(nCPAP),HFNC increased the treatment failure rate(P=0.032)and reduced the incidence rate of nasal injury(P=0.004)in children <5 years of age with severe pneumonia with respiratory failure and severe bronchiolitis.Compared with conventional oxygen therapy and nCPAP separately,HFNC had no statistically significant differences in intubation rate,hospital mortality,incidence of air leakage syndrome,total hospitalization time,length of ICU stay,and oxygen supply time(all P>0.05).Conclusions Based on the current clinical evidence,HFNC can be used as respiratory support for children <5 years of age with pneumonia,mild hypoxemia and mild to moderate bronchiolitis.It is not recommended for use in children <5 years of age with severe pneumonia with respiratory failure or severe bronchiolitis.

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(本文编辑:沈园园 刘于皛)

备注/Memo

备注/Memo:
【 收稿日期 】 2020-07-15 【 修回日期 】 2021-06-02
【 作者简介 】 林茜,硕士,护师,从事儿科护理研究
【 通信作者 】 刘勤,电话:0830-8950770
更新日期/Last Update: 2021-07-15