| 陈杰,钱超.经鼻高流量氧疗与无创正压通气治疗 COPD伴Ⅱ型呼吸衰竭的META分析[J].实用中西医结合临床,2022,22(1): |
| 经鼻高流量氧疗与无创正压通气治疗 COPD伴Ⅱ型呼吸衰竭的META分析 |
| Meta-analysis of intranasal high flow oxygen therapy and noninvasive positive pressure ventilation in the treatment of COPD with Ⅱ type respiratory failure |
| 投稿时间：2021-06-30 修订日期：2021-12-01 |
| DOI： |
| 中文关键词: 慢性阻塞性肺病 Ⅱ型呼吸衰竭；经鼻高流量质量 无创通气 荟萃分析；随机对照 |
| 英文关键词: COPD AHRF HFNT NIV Meta-analysis RCT |
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| 中文摘要: |
| 目的：系统评价经鼻高流量氧疗与无创正压通气治疗COPD 加重伴Ⅱ型呼吸衰竭的安全及有效性。方法 ：计算机检索 PubMed、The Cochrane Library、EMbase、CBM、CNKI、VIP 和 WanFang Data 数据库，查找关于经鼻高流量氧疗与无创正压通气治疗 AECOPD疗效的随机对照试验（RCT），检索时限均为从建库至 2020 年 04 月。由 2 位研究者按照纳入与排除标准筛选文献、提取资料和评价纳入研究的方法学质量后，采用 RevMan 5.3软件进行 Meta 分析。结果：共纳入13个RCT，1031例患者。综合分析结果表明,PaO2水平12小时和48小时HFNT组高于16组(P < 0.05),而鼻面部皮肤破裂的发生率5组显著高于HFNT组(P < 0.05)。HFNT组与NIV组相比，148hr组PaCO2水平更高(P<0.05)。两组治疗后12h- paco2、24h-PaO2、24-PaCO2、24h-PH、24h-RR、48h-PH、72h-PaO2、72-PaCO2、72h-PH差异无统计学意义(P>0.05)。结论:在COPD合并Ⅱ型呼吸衰竭患者中，与NIV相比，HFNT的使用并没有导致治疗失败率的增加。与NIV相比，HFNT具有更好的舒适性和耐受性，是一种新的潜在的COPD伴Ⅱ型呼吸衰竭患者呼吸支持治疗方法 |
| 英文摘要: |
| Background and objectives: To systematically review the clinical efficacy of high-flow nasal therapy versus non-invasive ventilation in treating patients with hypercapnic acute respiratory of chronic obstructive pulmonary disease (COPD).Methods: Databases including PubMed, The Cochrane Library, EMbase, CBM, CNKI, VIP and WanFang Data were searched for the randomized controlled trials (RCTs) about high-flow nasal therapy versus non-invasive ventilation in treating hypercapnic acute respiratory failure of COPD from the establishment to April 2020. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results: Thirteen RCTs involving 1031 patients were included . The results of this meta analysis show that the level of PaO2 in the 12 hours and 48 hours was higher in the HFNT group than in the NIV group（P<0.05）, whereas the incidence of nasal facial skin breakdown in the NIV group was significantly higher than that of the HFNT group（P<0.05）. The level of PaCO2 in the 48 hours was higher in the HFNT group than in the NIV group（P<0.05）. There were no significant differences in12h-PaCO2,24h-PaO2, 24-PaCO2, 24h-PH,24h-RR,48h-PH, 72h-PaO2, 72h-PaCO2, and 72h-PH after treatment between the two groups（P>0.05）.Conclusion: Among COPD patients with hypercarbic ARF, the use of HFNT compared with NIV did not result in increased rates of treatment failure. HFNC had better comfort and tolerance than NIV, and is a new potential respiratory support therapy for COPD patients with hypercarbic ARF |
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