无创性横向性硬化症的非侵入性机械通风辅助:一个系统的审查
Carolina da Cunha-Correia1, Mylana Dandara Pereira Gama2, Pedro Nogueira Fontana3
1PhD. Neurologist and Professor, Department of Neurology, Hospital Universitário Oswaldo Cruz (HUOC), Universidade de Pernambuco (UPE), Recife (PE), Brazil.
Sao Paulo medical journal = Revista paulista de medicina
|July 12, 2023
概括
非侵入性通风 (NIV) 通过缓解低通风症状,显著改善了肌缩侧面硬化症 (ALS) 患者的生存率和生活质量. 这种干预措施为标准护理提供了具有成本效益的替代方案,减少了住院治疗.
科学领域:
- 神经学 神经学
- 肺部病理学 肺部病理学
- 医疗技术 医疗技术 医学技术
背景情况:
- 呼吸衰竭是肌缩侧面硬化症 (ALS) 死亡的主要原因.
- 生活质量低下 (QOL) 是ALS患者显著的并发症.
- 非侵入性通风 (NIV) 显示了改善ALS生存率和QOL的潜力.
研究的目的:
- 为了评估NIV对ALS患者的疗效和安全性,对生存率和QOL进行评估.
- 通知医疗保健系统关于NIV在ALS管理中的好处.
主要方法:
- 根据PRISMA标准进行了系统审查.
- 在2022年1月之前进行广泛的数据库搜索 (科克兰图书馆,CENTRAL,MEDLINE,LILACS,EMBASE,CRD).
- 来自符合条件的研究数据的叙述综合,包括一个元分析和一个系统审查.
主要成果:
- 尼维有效地缓解慢性低通风症状.
- 与标准护理相比,接受NIV治疗的患者的生存率增加,QOL改善.
- 根据ALS的临床表型,观察到NIV的益处有所不同.
结论:
- 尼维增强了ALS患者的结果,并可以推迟气管切除术的需要.
- 实施NIV可以减少医疗保健支出,包括减少住院治疗和ICU床位占用.
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