文章摘要
个体化呼气末正压对全麻手术患者术后肺功能影响的Meta分析
Effect of individualized positive end-expiratory pressure on postoperative pulmonary function in patients undergoing general anesthesia: a meta-analysis
  
DOI：10.12089/jca.2022.08.014
中文关键词: 个体化  呼气末正压  肺保护通气策略  Meta分析
英文关键词: Individualized  Positive end-expiratory pressure  Lung protective ventilation strategy  Meta analysis
基金项目:
作者单位E-mail
翁丽波 225000,扬州大学附属苏北人民医院麻醉科  
陈小萍 225000,扬州大学附属苏北人民医院麻醉科 330989007@qq.com 
葛亚丽 225000,扬州大学附属苏北人民医院麻醉科  
高巨 225000,扬州大学附属苏北人民医院麻醉科  
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中文摘要:
      
目的 探索个体化呼气末正压（PEEP）对全麻手术患者术后肺功能的影响。
方法 检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、维普、万方数据库，收集个体化PEEP对全麻手术患者术后肺功能影响的随机对照试验（RCT），检索时间为建库至2021年6月。按照Cochrane指导手册进行文献筛选、资料提取和质量评价后，采用RevMan 5.3软件进行Meta分析。
结果 共纳入RCT研究17篇，共计患者1 355例，其中个体化PEEP组670例，固定PEEP组685例。与固定PEEP组比较，个体化PEEP组术后肺部并发症发生率明显降低（RR=0.60，95%CI 0.49～0.74，P<0.001），个体化PEEP组术中肺顺应性明显升高（SMD=1.41，95%CI 0.98～1.83，P<0.001），个体化PEEP组术后PaO2/FiO2明显升高（SMD=1.02，95%CI 0.61～1.43，P<0.001）。
结论 个体化PEEP可提高术中肺顺应性、改善术后氧合，降低全麻手术患者术后肺部并发症发生率。
英文摘要:
      
Objective To explore the effect of individualized positive end-expiratory pressure (PEEP) on postoperative pulmonary function of patients undergoing general anesthesia.
Methods Randomized controlled trials (RCTs) about the effect of individualized PEEP in postoperative pulmonary function in patients undergoing general anesthesia were searched in the PubMed, Cochrane Library, Embase, Web of Science, CNKI, VIP, and Wangfang data from the the year of establishment to June 2021. After literature screening, data extraction and quality assessment were performed according to the Cochrane guidelines. RevMan 5.3 software was used for meta-analysis.
Results Seventeen RCTs including 1 355 patients were enrolled, 670 patients in individualized PEEP group and 685 patients in fixed PEEP group. Compared with the fixed PEEP group, the incidence of postoperative pulmonary complications was significantly decreased in the individualized PEEP group (RR=0.60, 95% CI 0.49-0.74, P < 0.001), and intraoperative lung compliance was significantly increased in the individualized PEEP group (SMD = 1.41, 95% CI 0.98-1.83, P < 0.001), and postoperative PaO2 /FiO2 was significantly increased in the individualized PEEP group (SMD = 1.02, 95% CI 0.61-1.43, P < 0.001).
Conclusion Individualized PEEP can significantly enhance intraoperative lung compliance, improve oxygenation and reduce the incidence of postoperative pulmonary complications.
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