经鼻高流量氧疗在先天性心脏病术后 患儿撤机后应用效果的Meta 分析

科研论著·

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Abstract Objective： To compare the effect of high-flow nasal cannulae and conventional oxygen therapy in children with congenital heart disease after extubation postoperatively by Meta-analysis. Methods：The clinical controlled trials published in the Cochrane Library， PubMed， EMbase， Web of Science， CBM， CNKI， WanFang Database and VIP about the comparison of high-flow nasal cannulae and conventional oxygen therapy in children with congenital heart disease after extubation postoperatively were searched. The retrieval time was from the inception to June 2023. Meta-analysis was performed by RevMan 5. 3 software. Results：A total of 8 articles were included， including 720 pediatric patients. The results of Meta-analysis showed that compared with conventional oxygen therapy， high-flow nasal cannulae could reduce the re-intubation rate RR=0.30 ， 95% CI 0. 19-0. 47， P<0.000 01 ）， and the incidence of atelectasis（ RR=0.57 ， 95%CI 0. 37-0. 87， P=0.01 ）， and shorten the length of ICU hospitalization（ ， 95%CI-2.77--0.06， P=0.04 ）. Highflow nasal cannulae could improve PaO2 at 6， 12， 24， 48 h after extubation（ P<0.05 ， respectively）， reduce PaCO2 at 1，6，12h after extubation P<0.05 ， respectively）， and improve PaO2/FiO2 at 1，6，12，24，48h after extubation（ P<0.000 01 ）. There is no statistically significant difference in the impact of PaO2 at 1h and PaCO2 at 24， 48 h after extubation（ P>0.05 ， respectively）. Conclusion： Existing evidence suggests that high-flow nasal cannulae can reduce the rate of re-intubation and atelectasis in pediatric patients with congenital heart disease after extubation postoperatively， and shorten the ICU hospitalization time， improve PaO2 and PaO2/FiO2 ， reduce PaCO2 compared to conventional oxygen therapy.

Keywords high-flow nasal cannulae; conventional oxygen therapy; congenital heart disease; children; Meta-analysis; evidence-based nursing

摘要 目的：采用Meta 分析方法比较经鼻高流量氧疗与常规氧疗在先天性心脏病术后患儿撤机后的应用效果。（剩余10158字）