摘要
Abstract
Objevtive To assess the efficacy and safety of glucocorticoids treatment for meconium aspiration syndrome ( MAS ).Methods Besides manually searching, PubMed, MEDLINE, EMBASE.EBSCOhost, the Cochrane Library, the Cochrane Central Register of Controlled Trials ( CENTRAL ), Ovid, Chinese Biological Medic:al Literature Database ( CBM ),Wanfang Chinese Periodical Datase and VIP Chinese Periodical Database were electronically searched from the establsihment of the database till Decemher 2010.All randomized controlled trials ( RCTs ) about glucocortic:oid treatment initiated within postnatal 48 hours in MAS newborns were eligible.Standard methods of the Cochrane Collaboration were employed to evaluate the methodological quality of the trials.Meta-analysis was performed with RevMan 5.0.23 software, and proper effective model was used according to heterogeneity of the included studies.Descriptive analysis was utilized if meta-analysis was inappropriate.Results A total of 1 012 literatures were reviewed.Five RCTs enrolled with 295 participants were eligible for this meta-analysis, among them 1 trial was in low risk of bias.3 were moderate and 1 was in high risk of bias.Meta-analysis showed that glucocorticoid treatment significantly decreased the hospital stays ( MD = - 5.42.95％CI: - 7.38 to - 3.45.P ＜ 0.0001 ) and the incidenc:e of sepsis ( OR =0.33.95％ CI: 0.12 to 0.78, P = 0.01 ).Meta-analysis in subgroups indicated that budesonide inhalation decreased significantly the hospital stays( MD = - 6.11, 95％ CI: - 8.88 to - 3.34, P ＜ 0.000 1 ).the duration of respiratory distress ( SMD = - 1.56.95％ CI: - 2.12 to - 1.00,P＜0.000 01 ), the duration of oxygen therapy ( SMD = - 1.22.95％ CI: - 1.96 to -0.48.P = 0.001 ) and the incidence of sepsis ( OR = 0.25.95％ CI: 0.07 to 0.95.P = 0.04 ).None of glucocorticoid therapies significantly influenced the mortality during hospitalization.duration of chest X-ray clearance, or incidence of oral thrush,superficial fungal infection or meningitis.Descriptive analysis indicated that the glucocorticoids had no effect on the incidence of persistent pulmonary hypertension newborn, air leak, hyperglycemia, hypertension, chronic lung disease ( CLD ), delayed growth or development.Conclusions Budesonide suspension inhalation initiating within 48 hours postnatal in MAS newboms can significantly shorten hospital stays, duration of respiratory distress and oxygen therapy.Glucocorticoid treatment neither improves the final outcome of MAS newborns, nor increases the incidence of secondary infection.关键词
糖皮质激素/新生儿/胎粪吸入综合征/Meta分析/疗效/安全性
