中国循证儿科杂志2011，Vol.6Issue(5)：358-363,6.DOI:10.3969/j.issn.1673-5501.2011.05.009
雾化吸入高渗盐水治疗婴幼儿毛细支气管炎疗效和安全性的Meta分析
Efficacy and safety of nebulized hypertonic saline solution inhaling for acute bronchiolitis in infants:a meta-analysis
彭万胜 1陈信 1李冬娥 1张云莲 1王磊 1刘恩梅2
作者信息
- 1. 安徽省蚌埠医学院第一附属医院儿科,蚌埠,233004
- 2. 重庆医科大学附属儿童医院呼吸科,重庆,400014
- 折叠
摘要
Abstract
Objective Nebulized hypertonic saline inhaling may reduce the pathological changes of airway edema and mucus plugging and decrease airway obstruction.To assess the efficacy and safety of nebulized hypertonic saline inhaling as treatment to infants with acute bronchiolitis.Methods We searched the Cochrane Central Register of Controlled Trials ( CENTRAL ), containing the Cochrane Acute Respiratory Infections Group Specialized Register, EMBASE , PubMed, CNKI, Wan Fang Chinese periodical Database and VIP Chinese periodical Database from the establishment of the database to April 2011, hy using the terms( hypertonic saline solution AND bronchiolitis ).Randomized controlled trials ( RCTs ) and quasi-RCTs using nebulized hypertonic saline inhaling alone or in conjunction with bronchodilators as an active intervention in infants up to 24 months of age with acute bronchiolitis were selected.Two review authors independently assessed the potential risk of bias in included studies according to the Cochrane Collaboration -s recommendations.Dichotomous data were synthesized using OR and 95％ confidence intervals ( CI ) as the efficacy measures.The mean difference ( MD ) and 95％ CI were used to measure the effect size for continuous outcomes.The meta-analyses were performed using the Cochrane statistical package RevMan 5.1.1.Results Ten RCTs involving 853 infants with acute bronchiolitis were included.Patients treated with nebulized hypertonic saline inhaling had a significantly shorter mean length of hospital stay compared with the control group( MD = - 1.33 d,95％ CI: - 1.63 to - 1.03 d,P ＜0.000 01 ).The hypertonic saline group also had a significantly lower post-inhalation clinical score than the control group in the first three days treatment ( day 1 : MD = - 0.77 ,95％ CI : - 1.30 to - 0.24 ,P = 0.004 ; day 2 :MD = - 1.15.95％ CI: - 1.86 to - 0.44,P = 0.001 ; day 3 : MD = - 1.43.95％ CI - 1.87 to - 0.99,P ＜0.000 01 ).The effects of hypertonic saline inhaling on improving clinical score were observed in hoth outpatients and inpatients.Wheezing remission time( MD = - 1.16 d,95％ CI: - 1.43 to -0.89 d.P ＜0.000 01 ), cough remission time( MD = - 1.12 d,95％ CI: - 1.34 to -0.89 d.P ＜0.000 01 ) and the moist crackles disappearance time( MD = - 1.30 d, 95％CI: - 2.29 to - 0.32 d,P = 0.009 ) were significantly lower in the hypertonic saline group than in control group.Five trials failed to show significant effects of nebulized hypertonic saline inhaling on reducing the rate of hospitalization/risk of readmission.Two trials failed to show significant effects of nebulized hypertonic saline on improving radiograph assessment score.No significant adverse event related to hypertonic saline inhalation was reported.Conclusions Frequently inhaling hypertonic saline shortened length of hospital stay significantly and relieved symptoms and signs faster than control group for infants with bronchiolitis without apparent adverse effects.关键词
婴幼儿/毛细支气管炎/高渗盐水/疗效/安全性/Meta分析Key words
Infants / Bronchiolitis / Hypertonic saline solution / Efficacy / Safety / Meta-analysis引用本文复制引用
彭万胜,陈信,李冬娥,张云莲,王磊,刘恩梅..雾化吸入高渗盐水治疗婴幼儿毛细支气管炎疗效和安全性的Meta分析[J].中国循证儿科杂志,2011,6(5):358-363,6.
