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目的探讨不同浓度氧气复苏窒息极早产儿的临床效果。方法通过文献检索收集不同浓度氧气复苏窒息极早产儿的随机对照试验,采用RevMan 5.0分析软件,首先进行异质性检验,当结果不存在异质性,以固定效应模型描述,存在异质性时,以随机效应模型表达,将资料进行定量综合,采用比值比(OR)及其95%可信区间(95%CI)表示。结果共6篇文献符合条件纳入研究,其中4篇文献为B级,2篇文献为C级。累计低浓度氧(21%~50%)复苏组157例,高浓度氧(90%~100%)复苏组168例。不同氧浓度复苏对极早产儿复苏失败率(OR=2.03,95%CI:0.87~4.71)和病死率(OR=1.23,95%CI:0.53~2.86)无影响,对支气管肺发育不良(OR=1.07,95%CI:0.55~2.10)、颅内出血(OR=1.99,95%CI:0.76~5.23)、败血症(OR=1.00,95%CI:0.46~2.17)、早产儿视网膜病(OR=0.71,95%CI:0.18~2.73)、气胸(OR=0.28,95%CI:0.04~1.82)、动脉导管未闭(OR=0.74,95%CI:0.34~1.64)的发生率均无影响(P均<0.05)。结论不同浓度氧气复苏窒息极早产儿的效果无差异,但由于纳入文献质量有限,对于复苏开始的氧浓度、如何调整氧浓度、安全的血氧饱和度范围等问题仍需进一步大样本随机对照试验进行评价。
Objective To investigate the clinical effects of different concentrations of oxygen resuscitation asphyxia in very premature infants. Methods Randomized controlled trials of different concentrations of oxygen resuscitation asphyxia and very preterm premature children were collected by literature search. Using RevMan 5.0 software, we first conducted the heterogeneity test. When there was no heterogeneity in the results, the model was described by the fixed effect model, and there was heterogeneity , Expressed as a random-effect model, and the data were quantitatively combined using a odds ratio (OR) and its 95% confidence interval (95% CI). Results A total of 6 articles were included in the study. Four of them were Grade B and two were Grade C. A total of 157 cases of low oxygen (21% -50%) resuscitation and 168 cases of high oxygen (90% -100%) resuscitation were accumulated. Resuscitation with different oxygen concentrations had no effect on the rate of resuscitation failure (OR = 2.03, 95% CI: 0.87-4.71) and mortality (OR = 1.23, 95% CI: 0.53-2.86) = 1.07, 95% CI: 0.55-2.10), intracranial hemorrhage (OR = 1.99, 95% CI: 0.76-5.23), sepsis (OR = 1.00,95% CI: 0.46-2.17), retinopathy of prematurity (OR = 0.71, 95% CI: 0.18-2.73), pneumothorax (OR = 0.28, 95% CI: 0.04-1.82) and patent ductus arteriosus (OR = 0.74, 95% CI: 0.34-1.64) P <0.05). Conclusion There is no difference in the effect of oxygen resuscitation and asphyxia in very preterm infants. However, due to the limited quality of the included literature, there are still some large randomized controlled trials on how to adjust the oxygen concentration and the safe range of oxygen saturation for resuscitation Evaluation.