非手术干预对阻塞性睡眠呼吸暂停病人血压影响的网状Meta分析

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Abstract Objective：To evaluate the effect of non－surgical interventions on blood pressure in patients with obstructive sleep apnea（OSA） using Bayesian network Meta－analysis.Methods：Seven Chinese－English databases including PubMed，the Cochrane Library，EMbase，Web of Science，CBM，CNKI and WanFang Database were systematically searched，and all randomized controlled trials on the effects of non－surgical interventions on blood pressure of OSA patients from the establishment of the database to December 31，2021 were searched.The Cochrane Risk Assessment Scale was used to evaluate the quality of the included documents，Stata15.0 was used to draw the network graph，and Gemtc 13.4 was used for statistical analysis.Results：A total of 19 articles were included，involving 7 individual interventions，1 combined intervention and placebo control.Network Meta－analysis results showed that in terms of reducing diastolic blood pressure，lifestyle+continuous positive airway pressure ventilation>continuous positive airway pressure ventilation>mandibular propulsion device>comfort control>oral appliances=acupuncture> inspiratory muscle training>posture maintainer>weight loss therapy.Compared with the posture maintainer group and the comfort control group，continuous positive airway pressure ventilation had a better effect on reducing diastolic blood pressure， and the difference was statistically significant（P<0.05）.In terms of reducing systolic blood pressure，posture maintainer>lifestyle+continuous positive airway pressure ventilation>continuous positive airway pressure ventilation>mandibular propulsion device>comfort control>oral appliances>acupuncture>weight loss therapy>inspiratory muscle training.The effect of posture maintainer was better than that of the placebo control group，and the difference was statistically significant（P<0.05）.There was no statistically significant difference between other interventions.Conclusion：Current evidenle shows that the effect of continuous positive airway pressure breathing mode intervention alone or combined with lifestyle intervention on reducing diastolic and systolic blood pressure in OSA patients is relatively stable.

Keywords sleep apnea，obstructive;non－surgical intervention;network Meta－analysis;blood pressure;evidence－based nursing

摘要 目的：使用贝叶斯网状Meta分析方法评价非手术干预措施对阻塞性睡眠呼吸暂停（OSA）病人血压的影响。（剩余13519字）