抗生素吸入及静脉注射联合应用治疗呼吸机相关肺炎的效果评.PDFVIP

• 228 • Chinese Journal of Respiratory and Critical Care Medicine, May 2017, Vol. 16, No.3   ·论　　著· 抗生素吸入和静脉注射联合应用治疗 呼吸机相关肺炎的效果评价 彭东风，查日田，陈新华，魏进莲 芜湖市第一人民医院呼吸内科（安徽芜湖  241000 ） 【摘要】   目的    评价抗生素吸入联合静脉注射对治疗呼吸机相关性肺炎（VAP ）的应用效果。 方法    计算 机检索 Cochrane library、Joanna Briggs Institute Library、PubMed、MEDLINE、CINAHL、CBM、CNKI 及万方医学网 中关于抗生素吸入联合静脉注射治疗 VAP 的文献。由 3 名研究者对文献质量进行严格评价和资料提取，对符合 质量标准的进行 Meta 分析。 结果    共纳入 13 项研究。结果显示试验组 VAP 患者治愈率高于对照组，差异有统 计学意义（RR=1.16，95%CI 1.07 ～1.56，P=0.000 5）；两组死亡率（RR=1.04，95%CI 0.82 ～1.32，P=0.74）和肾功能损 害发生率（RR =0.79 ，95% CI 0.51 ～1.22，P =0.29 ）差异均无统计学意义。致病菌清除方面差异有统计学意义 （RR=1.38，95%CI 1.09 ～1.74，P=0.007），试验组患者呼吸道分泌物培养致病菌转阴率更高。 结论    抗生素吸入联 合静脉注射可以提高 VAP 患者的治愈率，有效地清除致病菌，建议临床推广使用。 【关键词】  抗生素；吸入；静脉注射；呼吸机相关肺炎 Effectiveness of inhaled antibiotics combined with intravenous administration for treatment of ventilator-associated pneumonia: a systematic review PENG Dongfeng, CHA Ritian, CHEN Xinhua, WEI Jinlian Department of Respiratory Medicine, Wuhu No.1 Hospital, Wuhu, Anhui 241000, P.R.China Corresponding author: PENG Dongfeng, Email: 1968360409@ 【Abstract 】 Objective    To evaluate the effects of inhalation combined intravenous antibiotics for the treatment of ventilator-associated pneumonia. Methods    A computerized search was performed through Cochrane library, Joanna Briggs Institute Library, PubMed, MEDLINE, CINAHL, CBM, CNKI and Wangfang medical network about inhalation combined intravenous antibiotics therapy in ventilator-associated pneumonia in the literatures. The data extracting and quality assessment were performed by three researchers. The meta-analysis was performed by RevMan 5.3 software. Results    Thirteen studies was included for analysis. The results showed that the cure rate was higher in the experimental group compared with the control group with significant difference (RR=1.16, 95% CI 1.07 to 1.56, P=0.000 5). There were