在接受外科手术的患者中进行外科氧气治疗:系统性审查和元分析的概述
Adel Elfeky1, Yen-Fu Chen1, Amy Grove1
1Warwick Medical School, University of Warwick, Coventry, UK.
Health technology assessment (Winchester, England)
|September 15, 2025
概括
目前关于外科手术期间氧气治疗的证据表明,在手术患者中,高或低比例的灵感氧气没有明显的益处. 需要进一步的研究来确定最佳的氧气策略及其对术后并发症的影响.
科学领域:
- 麻醉学和重症监护医学
- 呼吸系统医学 呼吸系统医学
- 手术结果研究研究.
背景情况:
- 在外科手术期间给予氧气是一种减轻术后并发症的建议策略.
- 各种外科手术期间氧气策略的临床有效性仍然不确定.
- 需要为临床实践和未来研究提供基于证据的建议.
研究的目的:
- 为了提供一个全面的概述的外科手术期间氧气治疗的有效性.
- 为临床决策制定基于证据的建议.
- 为了指导未来的研究方向在外科手术期间的氧气管理.
主要方法:
- 现有系统性审查和随机对照试验 (RCT) 的系统性审查和元分析.
- 遵循PRISMA (系统审查和元分析的首选报告项目) 的指导方针.
- 评估了偏差风险,证据确定性 (GRADE),并进行了试验顺序分析.
主要成果:
- 低确定性证据表明,高比例的吸入氧气可能会略微减少手术部位感染,但会增加脱氧.
- 有证据表明,高比例的吸入氧气对肺部并发症,死亡率和住院的影响是不确定的或几乎没有差异.
- 术后高流量鼻氧和非侵入性通风显示出对呼吸支和并发症的潜在益处,但证据非常不确定.
结论:
- 证据不足以支持常规使用非侵入性通风或高流量鼻氧.
- 没有明确的证据表明,高或低比例的吸入氧气可以改善手术患者的治疗结果.
- 需要进一步进行高质量的RCT,以澄清术后氧气策略的有效性.
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