纤维支气管镜灌洗治疗急性肺脓肿有效性的Meta分析

Meta analysis of the effectiveness of bronchofiberscope lavage in treatment of acute lung abscess

目的通过对纤维支气管镜灌洗治疗急性肺脓肿有效性进行Meta分析,为临床工作中是否优先采取此治疗方案提供有效证据。方法运用计算机检索在中国知网(CNKI)、维普(VIP)、万方、PubMed、Embase、Cochrane等中、英文数据库中发布的有关纤维支气管镜灌洗治疗急性肺脓肿有效性的临床研究,检索时间为2010年1月1日至2018年12月1日。由2名研究员根据原先设定的文献纳入和排除标准获取相关资料,通过Cochrane偏倚风险评估工具评价纳入文献的质量,采用Mevman 5.3软件进行统计学分析。结果最后纳入文献20篇,患者共1332例,对其进行汇总分析。结果表明:纤维支气管镜灌洗治疗急性肺脓肿,有效率较常规治疗组高[RR=1.27,95%CI(1.18,1.37),P<0.01],第1秒用力呼气流量(FEV 1)水平[WMD=0.36,95%CI(0.29,0.42),P<0.01]及动脉氧分压(PaO 2)水平[WMD=9.12,95%CI(7.94,10.30),P<0.01]的改善程度较常规治疗组明显,住院时间[WMD=-9.96,95%CI(-12.95,-6.96),P<0.01]、体温恢复时间[WMD=-4.29,95%CI(-5.29,-3.29),P<0.01]、咳嗽咳痰缓解时间[WMD=-3.91,95%CI(-4.43,-3.40),P<0.01]、脓腔消失时间[SMD=-1.74,95%CI(-2.63,-0.86),P=0.0001]也较常规治疗组短。结论当前的临床研究数据显示:纤维支气管镜灌洗在治疗急性肺脓肿方面有其独特的优势。

Objective To prove the effectiveness of bronchofiberscope lavage in the treatment of acute lung abscess and provide basis for its priority in clinical work.Methods Chinese and English databases such as(CNKI),(VIP),Wanfang,PubMed,Embase,Cochrane,etc.were searched for the clinical effectiveness of bronchofiberscope lavage in the treatment of acute lung abscess from January 1,2010 to December 1,2018.Two researchers obtained relevant data according to the original document inclusion and exclusion criteria,and the quality of the included literature was evaluated by the Cochrane bias risk assessment tool.Statistical analysis was performed with Mevman 5.3 software.Results Altogether,20 articles were included in the literature,and a total of 1332 patients were analyzed.The results showed that bronchofiberscope lavage for acute lung abscess was more effective than conventional treatment group(RR=1.27,95%CI[1.18,1.37],P<0.01),FEV 1 level(WMD=0.36,95%CI[The improvement of 0.29,0.42],P<0.01)and its PaO 2 level(WMD=9.12,95%CI[7.94,10.30],P<0.01)was significantly higher than that of the conventional treatment group,and its hospitalization time(WMD=-9.96,95%CI[-12.95,-6.96],P<0.01),body temperature recovery time(WMD=-4.29,95%CI[-5.29,-3.29],P<0.01),cough and sputum relief time(WMD=-3.91,95%CI[-4.43,-3.40],P<0.01),diminution time of abscess(SMD=-1.74,95%CI[-2.63,-0.86],P=0.01)were also shorter than thoseofthe conventional treatment group.Conclusion Current clinical research data show thatfiberoptic bronchoscopy has its unique advantages in the treatment of acute lung abscess.