外源性肺表面活性物质对新生儿呼吸窘迫综合征影响的系统评价

摘要

Objective To assess the effect of pulmonary surfactant on neonatal respiratory distress syndrome. Methods The randomized controlled study involving in pulmonary surfactant on neonatal respiratory distress syndrome were searched and identified from China Academic Journal Database, Chinese Biomedical Literature Database and Wan Fang Database. To carry out experiment according to inclusion and exclusion criteria and to evaluate quality of choice experiment, then to extract the valid data for meta - analysis. Results We collected 13 articles including 1219 patients. Meta analysis showed ①the time of mechanical ventilation; the time of mechanical ventilation was lower in experimental group than in control group (P < 0. 001) . ②hospital stay; compared with control group, experiment group could significantly reduced hospital stay, and the difference was statistically significant (P< 0.001). ③mortality rate; compared with control group, mortality rate reduced significantly in experimental group, and the difference was statistically significant( P < 0. 001). ④complication rate; the complication rate was lower in experimental group than in control group, and the difference was statistically significant ( P < 0. 001 )⑤ There was no statistical difference between two groups in hospitalization costs(P =0.94) , the rate of chest improvement after 24 h(P =0.49) , the rate of chest improvement after 72 h(P=0. 07). Conclusion The existing clinical evidences show that, compared to conventional therapy, addition of exogenous pulmonary surfactant can reduce mechanical ventilation time, hospital stay, the incidence of complications and improve survival rate in the patients with neonatal respiratory distress syndrome. Due to the quality of research and the limitations of study samples, there may be a high degree of selection bias and measurement bias, so we need further high - quality retrieval of foreign - related literature to determine its clinical value.%目的 评价外源性肺表面活性物质(PS)对新生儿呼吸窘迫综合征(NRDS)的影响.方法 计算机检索中国学术期刊全文数据库、中国生物医学文献数据库和万方资源数据库并手工检索相关期刊,全面收集PS治疗NRDS随机对照研究,按纳入、排除标准选择试验并评价质量,而后提取有效数据进行Meta分析.结果 最终纳入13篇文献,包括 1219例患者(实验组611例,对照组608例).Meta分析结果 显示,实验组机械通气时间明显短于对照组(P<0.001);实验组住院时间时显短于对照组(P<0.001);实验组死亡率明显低于对照组(P<0.01);实验组并发症发生率明显低于对照组(P<0.01);两组住院费用比较差异无统计学意义(P=0.94);两组24 h胸片改善率比较差异无统计学意义(P=0.49);两组72 h胸片改善率比较差异无统计学意义(P=0.07).结论 现有临床研究证据显示,与常规治疗相比,加用外源性PS能减少NRDS患者机械通气时间、住院时间,降低并发症发生率,提高生存率.