ICU气管插管病人吸痰前行无菌生理盐水灌注对生命体征影响的系统评价

Influence of normal saline perfusion on vital signs of patients with ICU tracheal intubation before sputum suction:a systematic evaluation

[目的]探讨ICU气管插管病人吸痰前进行无菌生理盐水灌注对病人生命体征的影响。[方法]通过检索PubMed、Embase、Cochrane Central Register of Controlled Trials,CINAHL,中国期刊全文数据库(CNKI)和万方数据库等资源,收集吸痰前进行无菌生理盐水灌注对于ICU气管插管病人生命体征影响的随机对照试验,并进行文献质量评价和数据提取,结局指标包括心率、血氧饱和度、血压。[结果]最终纳入5项研究,文献证据质量大多为中等。Meta分析结果显示:与对照组相比,吸痰前进行无菌生理盐水灌注,不仅降低了吸痰后即时血氧饱和度,同时还降低了吸痰后2min以及5min的血氧饱和度,差异有统计学意义(P<0.01)。此外,吸痰前进行无菌生理盐水灌注对心率以及收缩压的影响并无统计学意义(P>0.05)。[结论]ICU气管插管病人吸痰前进行无菌生理盐水灌注并不一定能让病人获益。未来研究中仍然要克服相应的方法学缺陷。

Objective：To explore the influence of normal saline perfusion on vital signs of patients with ICU tracheal intubation before sputum suction.Methods：The randomized controlled trials（RCTs）of the influence of normal saline perfusion on vital signs of patients with ICU tracheal intubation before sputum suction were retrieved from PubMed,Embase,Cochrane Central Register of Controlled Trials,CINAHL,China journal full-text database（CNKI）,and Wanfang database.Literature evaluation and data extraction were conducted,including outcome indicators：heart rate,blood oxygen saturation,and blood pressure.Results：A total of 5 literatures were eventually included in this study.Most of the literatures had a moderate quality of documentary evidence.Meta-analysis results showed that compared with the control group,the sputum suction with normal saline infusion ahead,not only could reduce the instant oxygen saturation after sputum suction,but also decrease blood oxygen saturation 2 min and 5 min after the sputum suction,the difference was statistically significant（P〈0.01）.In addition,there was no statistically significant effect on heart rate and systolic blood pressure（P〉0.05）.Conclusion：Patients with ICU endotracheal intubation were not always able to benefit from the normal saline infusion before sputum suction.The corresponding methodological defects should be overcome in future research.