选择性消化道去污染预防呼吸机相关性肺炎的Meta分析
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王建荣

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R181.3+2

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Selective decontamination of digestive tract for preventing ventilatorassociated pneumonia:a Metaanalysis
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    摘要:

    目的运用循证医学理论和方法,对选择性消化道去污染(SDD)预防呼吸机相关性肺炎(VAP)的效果进行Meta分析。方法计算机检索1995—2014年PubMed、EMBASE、中国生物医学文献数据库CBMdisc、中国学术期刊全文数据库CNKI、维普中文生物医学期刊数据库,以及Cochrane library (2014年第12期)共6个医学数据库,筛选文献,进行数据资料提取及质量评价,应用RevMan 5.3软件进行统计分析。结果共纳入13篇文献 (包含2 676例患者),Meta分析结果显示,治疗组和对照组VAP发病率分别为20.68%、35.99%,OR及95%CI为0.40 (0.28,0.56),两组比较差异有统计学意义(P<0.001);治疗组和对照组机械通气患者病死率分别为20.60%、20.03%, OR及95%CI 为0.99 (0.81,1.20),两组比较差异无统计学意义 (P=0.91)。结论SDD能降低机械通气患者VAP发病率,但尚不能认为SDD能降低机械通气患者病死率。

    Abstract:

    ObjectiveTo evaluate the effect of selective decontamination of digestive tract(SDD) on preventing ventilatorassociated pneumonia by Metaanalysis based on theory and method of evidencebased medicine. MethodsSix medical databases ( PubMed, Excerpta Medica Database [EMBASE], China Biology Medicine disc[CBMdisc], China National Knowledge Infrastructure[CNKI], VIP database, from 1995 to 2014,  and Cochrane Library of issue 12,2014) were searched, literatures were selected, data were extracted, Metaanalysis was performed by using RevMan 5.3 software. Results13 literatures were included (2 676 patients were involved), Metaanalysis revealed that the incidence of VAP in treatment and control group was 20.68% and 35.99% respectively (OR and 95%CI,0.40 [0.28,0.56], P<0.001),the mortality rate of patients with mechanical ventilation in treatment group and control group were 20.60% and 20.03% respectively (OR and 95%CI,0.99 [0.81,1.20],P=0.91). ConclusionSDD can  reduce the incidence of VAP in patients with mechanical ventilation, but can’t reduce mortality rate.

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郭亮梅,王建荣,王静.选择性消化道去污染预防呼吸机相关性肺炎的Meta分析[J]. 中国感染控制杂志,2015,14(9):587-592. DOI:10.3969/j. issn.1671-9638.2015.09.003.
GUO Liangmei, WANG Jianrong, WANG Jing. Selective decontamination of digestive tract for preventing ventilatorassociated pneumonia:a Metaanalysis[J]. Chin J Infect Control, 2015,14(9):587-592. DOI:10.3969/j. issn.1671-9638.2015.09.003.

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  • 收稿日期:2015-01-08
  • 最后修改日期:2015-03-22
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  • 在线发布日期: 2015-09-30
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