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目的对早期或晚期咖啡因治疗早产儿呼吸暂停的临床疗效进行Meta分析。方法检索Medline、Science Direct、Elsevier、Embase、中国生物医学文献数据库、万方数据库等,收集符合纳入标准的研究,检索时限为从建库至2015年11月,提取符合纳入标准研究的参考文献和手工检索相关会议资料。由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,应用Rev Man 5.2软件进行Meta分析。结果共纳入1个随机对照研究,4个回顾性队列研究,共59 288例患儿,Meta分析结果显示,早期咖啡因使用组与晚期咖啡因使用组相比,病死率、支气管肺发育不良、脑室内出血、脑室旁白质软化、早产儿视网膜病及动脉导管未闭手术干预发生率均显著下降(P<0.05),坏死性小肠结肠炎发生率两组间比较差异无统计学意义(OR=0.98,95%CI0.72~1.33,P=0.881)。结论早产儿呼吸暂停患儿应尽早开始咖啡因治疗,能显著降低病死率及其他并发症的发生,无明显药物不良反应,临床耐受性好。
Objective To analyze the clinical efficacy of early or late caffeine in the treatment of apnea in preterm infants. METHODS: Medline, Science Direct, Elsevier, Embase, China Biomedical Literature Database and Wanfang Database were searched to collect the research that met the inclusion criteria. The search time was from the database construction to November 2015, Manually retrieve relevant conference materials. After two researchers independently screened the literature according to inclusion and exclusion criteria, extracted data and evaluated the quality, Meta-analysis was performed using Rev Man 5.2 software. Results A total of 5928 children were enrolled in a retrospective cohort study with 4 retrospective cohorts. Meta-analysis showed that mortality rate, bronchopulmonary dysplasia, bronchopulmonary dysplasia, The incidence of intraventricular hemorrhage, periventricular white matter softening, retinopathy of prematurity and patent ductus arteriosus were significantly decreased (P <0.05), and the incidence of necrotizing enterocolitis was no significant difference between the two groups (OR = 0.98 , 95% CI 0.72-1.33, P = 0.881). Conclusion Children with apnea in preterm infants should start caffeine treatment as soon as possible, which can significantly reduce the incidence of mortality and other complications, no obvious adverse drug reactions and good clinical tolerance.