不同体位干预预防呼吸机相关性肺炎有效性的Meta分析

Meta analysis of the effectiveness of different body position intervention in the prevention of ventilator associated pneumonia

目的:比较30°~45°半坐卧位与抬高床头<30°(包括平卧位)预防呼吸机相关性肺炎(VAP)的效果。方法:按照纳入和排除标准在国内数据库检索相关随机对照试验进行Meta分析,采用随机效应模式或固定效应模式分析优势比和95%置信区间,对连续性变量资料采用标准化均值差进行分析。结果:共纳入7篇文献。Meta分析结果显示:30°~45°半坐卧位与抬高床头<30°相比,30°~45°半坐卧位可有效地降低符合临床诊断标准的VAP发生率、缩短机械通气时间。结论:30°~45°半坐卧位可有效地降低符合临床标准的VAP发生率、缩短机械通气时间。

Objective:To compare the effect of 30 degrees to 45 degrees semirecumbent position and raising the bed below 30degrees(including the supine position) in the prevention of ventilator associated pneumonia.Methods:In accordance with the inclusion and exclusion criteria,we searched the relevant randomized controlled trials for Meta analysis in the domestic database,we analyzed the dominance ratio and 95% confidence intervals by using random effects or fixed effects models,we analyzed continuous variable data using standardized mean difference.Results:A total of 7 articles were included.Meta analysis results showed that:compared 30 degrees to 45 degrees semirecumbent position with raising the bed below 30 degrees,30 degrees to 45 degrees semirecumbent position can effectively reduce the incidence of VAP in accordance with the clinical diagnostic criteria,and shorten the time of mechanical ventilation.Conclusion:30 degrees to 45 degrees semirecumbent position can effectively reduce the incidence of VAP in accordance with the clinical diagnostic criteria,and shorten the time of mechanical ventilation.