气管切割时间对接受机械呼吸的患者的影响:随机对照试验的元分析
Rongrong Han1, Xiang Gao2, Yongtao Gao3
1Department of Otolaryngology, Weifang People's Hospital, Weifang, Shan dong Province, China.
PloS one
|July 23, 2024
概括
机械通风成年人的早期气管切除术缩短了机械通风的持续时间和ICU停留时间. 然而,它没有显著降低死亡率或肺炎发病率,根据这一分析.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
- 手术手术手术手术手术手术手术手术手术手术
背景情况:
- 机械通风是重症患者的维持生命的治疗方法.
- 气管切除术是重症监护室 (ICU) 中常见的一种手术,以促进长时间的机械通风.
- 气管切除术的最佳时间仍然是正在进行的临床辩论的主题.
研究的目的:
- 评估早期和晚期气管切除术时间对患者结果的影响.
- 综合来自随机对照试验 (RCT) 关于气管切除术时间的证据.
主要方法:
- 在PubMed,Embase,Web of Science和Cochrane图书馆进行了系统的文献搜索.
- 两个独立的审查者确定并选了比较早期和晚期气管切除术的相关RCT.
- 提取了数据,并使用Stata 14.0和RevMan 5.4软件进行了元分析.
主要成果:
- 在分析中包括了21个RCT.
- 早期气管切除术与机械呼吸持续时间 (MD: -2.77天) 和ICU停留时间 (MD: -6.36天) 的显著减少有关.
- 在所有原因死亡率 (RR:0.86),肺炎发病率 (RR:0.86) 或整体住院时间方面没有发现显著差异.
结论:
- 在机械通风患者中早期进行气管切除术可能会导致机械通风和ICU持续时间缩短.
- 早期气管切除术没有显示出在减少全因死亡率或肺炎发病率方面有显著的益处.
- 进一步的研究可能是有必要的,以探索其他潜在的益处或特定的患者子组.
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