摘要
目的系统评价布地奈德雾化吸入治疗新生儿胎粪吸入综合征(MAS)的疗效和安全性。方法计算机检索EMbase、PubMed、Cochrane、Wanfang Data、the ISI Web of Knowledge Databases、CBM、VIP和CNKI数据库,查找关于布地奈德雾化吸入治疗新生儿胎粪吸入综合征研究文献,检索时间均从建库至2022年5月31日。2位研究者独立进行文献筛选、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入9篇相关研究,共533例患者。Meta分析结果显示:①有效性:布地奈德组患儿住院时间、吸氧时间、呼吸窘迫缓解时间、血氧饱和度恢复时间、湿罗音消失时间、发绀消失时间明显短于对照组(P均<0.01),X线转归清晰时间与对照组差异无统计学意义;②安全性:布地奈德组患儿总并发症及不良反应发生率降低,差异有统计学意义(P<0.01)。亚组分析显示,布地奈德组患儿的呼吸窘迫综合征发生率降低,差异具有统计学意义(P<0.01);其他并发症及不良反应的发生率,包括急性肺损伤、气胸、脑膜炎、真菌感染、鹅口疮、败血症、癫痫、低血压、低血糖及高胆红素血症的发生率,与对照组差异均无统计学意义(P>0.05)。结论布地奈德雾化吸入治疗MAS可改善MAS患儿症状、体征,改善血气分析指标,加快病情康复,缩短病程,降低呼吸窘迫综合征的发生风险,且不会增加脑膜炎、败血症、真菌感染等不良反应的发生情况。
Objective To systematically evaluate the clinical efficacy and safety of budesonide aerosol inhalation in the treatment of meconium aspiration syndrome(MAS)in neonates.Methods The Cochrane library,PubMed,Wanfang Data,the ISI Web of Knowledge Databases,CBM,EMbase,VIP and CNKI Databases were searched and the retrieval time was from database establishment to May 31,2022.All randomized controlled trials(RCTs)about budesonide aerosol inhalation in the treatment of neonatal meconium aspiration syndrome were searched.After two researchers independently screened the literature,extracted data,and evaluated the risk of bias of the included studies,the Meta-analysis was performed by using the RevMan 5.3 software.Results A total of 9 related studies with 533 patients were included.The results of this Meta-analysis showed that:①Effectiveness:the hospitalization time,oxygen inhalation time,respiratory distress relief time,blood oxygen saturation recovery time,moist rales disappearance time,and cyanosis disappearance time in the budesonide group were significantly shorter than those in the control group(P<0.01),the X-ray outcome time was not significantly different from the control group;②Safety:The incidence of total complications and adverse reactions in the budesonide group was significantly lower,and the difference was statistically significant(P<0.01).Subgroup analysis showed that the incidence of respiratory distress syndrome in children in the budesonide group was significantly lower(P<0.01);the incidence of other complications and adverse reactions,including acute lung injury,pneumothorax,and meningitis,fungal infection,thrush,sepsis,epilepsy,hypotension,hypoglycemia and hyperbilirubinemia incidence,and the control group were not statistically different(P>0.05).Conclusion Budesonide aerosol inhalation treatment can improve the symptoms and signs of children with MAS,improve blood gas analysis indicators,accelerate the recovery of the disease,shorten the course of the disease,reduce the risk of respiratory distress syndrome,and do not increase the incidence of meningitis,sepsis,fungal infection and other adverse events.
作者
刘涛
雷亮
张翊溦
谭璐
胡娟
LIU Tao;LEI Liang;HU Juan(Department of Pharmacy,The First People's Hospital of Xianning,Xianning Hubei 437000,China)
出处
《湖北科技学院学报（医学版）》
2023年第4期319-325,共7页
Journal of Hubei University of Science and Technology(Medical Sciences)
关键词
胎粪吸入综合征
布地奈德
META分析
系统评价
随机对照试验
Meconium aspiration syndrome
Budesonide
Meta-analysis
Systematic evaluation
Randomized controlled trial
作者简介
通讯作者:胡娟,E-mail:42900868@qq.com。
