口咽部吸引预防呼吸机相关性肺炎效果的Meta分析

Effects of oropharyngeal aspiration for the prevention of ventilator-associated pneumonia:a Meta-analysis

目的评估口咽部吸引对降低呼吸机相关性肺炎的效果,以期为临床操作与实践提供依据。方法计算机检索中国知网、万方、中国生物医学文献数据库、维普、PubMed、Embase、Cochrane Library、Web of Science和CINAHL数据库关于口咽部吸引对呼吸机相关性肺炎影响的相关研究,同时筛选纳入的参考文献,检索时限为建库至2023年1月1日。由2名经过循证培训的研究者对纳入的文献质量进行评价和资料提取,并采用RevMan 5.4软件进行Meta分析。结果口咽部吸引可降低呼吸机相关性肺炎的发生率(OR=0.30,95%CI 0.22~0.40,P<0.01)、缩短机械通气时间(MD=-2.39,95%CI-3.59~-1.20,P<0.01)及缩短ICU的住院时间(MD=-2.62,95%CI-2.99~-2.26,P<0.01)。结论加强口咽部吸引能降低机械通气患者呼吸机相关性肺炎发生率,在临床实践过程中,应在体位改变时进行口咽部吸引,有条件者可进行持续吸引。

ObjectiveTo evaluate the effect of oropharyngeal aspiration on reducing ventilator-associated pneumonia,in order to provide a basis for clinical operation and practice.MethodsCNKI,Wanfang,China Biology Medicine Disc,VIP,PubMed,Embase,Cochrane Library,Web of Science and CINAHL databases were searched for relevant studies on the effects of oropharyngeal attraction on ventilators associated pneumonia.At the same time,the included references were screened,and the search time limit was from the establishment of the database to January 1,2023.The quality of the included literature was strictly evaluated and data extracted by two researchers with evidence-based training,and Meta-analysis was performed by RevMan 5.4 software.ResultsThe results of meta-analysis showed that oropharyngeal aspiration could reduce the incidence of ventilator-associated pneumonia(OR=0.30,95%CI 0.22-0.40,P<0.01)and shorten the duration of mechanical ventilation(MD=-2.39,95%CI-3.59--1.20,P<0.01)and reduced length of stay in ICU(MD=-2.62,95%CI-2.99--2.26,P<0.01).ConclusionsStrengthening oropharyngeal aspiration can reduce the incidence of ventilator-associated pneumonia in patients with mechanical ventilation.In clinical practice,oropharyngeal aspiration should be performed when the position changes,and continuous aspiration can be performed if conditions are met.