Chinese Journal of Nursing ›› 2020, Vol. 55 ›› Issue (1): 141-147.DOI: 10.3761/j.issn.0254-1769.2020.01.025

• Evidence Synthesis Research • Previous Articles     Next Articles

Inspiratory muscle training in patients with mechanical ventilation:a meta-analysis

YAO Li,YANG Lin,YANG Liping,ZHANG Zhigang(),ZHANG Caiyun,DING Nannan,TIAN Jinhui   

  • Received:2019-01-30 Online:2020-01-15 Published:2020-01-17
  • Contact: Zhigang ZHANG

机械通气患者吸气肌训练效果的Meta分析

姚丽,杨琳,杨丽平,张志刚(),张彩云,丁楠楠,田金徽   

  1. 730000 兰州市 兰州大学第一医院护理部(姚丽,张彩云,丁楠楠),特需外科(杨丽平),重症医学科(张志刚);兰州大学护理学院(杨琳),循证医学中心(田金徽)
  • 通讯作者: 张志刚
  • 作者简介:姚丽:女,本科(硕士在读),护师,E-mail:liyao5452@126.com
  • 基金资助:
    甘肃省自然科学基金(17JR5RA266)

Abstract:

Objective To evaluate the effectiveness of inspiratory muscle training(IMT) among patients with mechanical ventilation(MV). Methods We searched databases including Cochrane Library,PubMed,Web of Science,EMbase,CBM,CNKI and Wanfang Data. We used RevMan 5.3 software to conduct meta-analysis. Results A total of 21 RCTs including 1,014 patients were included in this meta-analysis. The meta-analysis showed that IMT could improve terminal maximal inspiratory pressure(MIP),difference MIP,PaO2 and SaO2[WMD and 95%CI were 7.98(7.22,8.73);5.76(4.23,7.29);9.55(4.00,15.10);2.00(1.15,2.85)];decrease duration of MV,duration of weaning and length of stay in ICU[SMD/WMD and 95%CI were -0.33(-0.52,-0.14);-0.99(-1.50,-0.48);-3.46(-5.36,-1.56)],and reduce mortality[RR=0.55,95%CI(0.33,0.91),P=0.02]. Conclusion IMT was effective in improving MIP and respiratory muscle strength and endurance,improving patients’ oxygenation status,and reducing duration of MV,weaning,length of stay in ICU,and mortality.

Key words: Inspiratory Muscle Training, Mechanical Ventilation, Intensive Care, Randomized Controlled Trial, Meta-Analysis

摘要:

目的 评价吸气肌训练在机械通气患者中的应用效果。方法 计算机检索Cochrane Library、PubMed、Web of Science、Embase、中国生物医学文献数据库、中国学术期刊全文数据库和万方数据库中有关机械通气患者吸气肌训练效果的随机对照试验,采用RevMan 5.3软件进行Meta分析。结果 最终纳入21篇文献,共1 014例患者。Meta分析结果显示,吸气肌训练能有效改善机械通气患者训练后最大吸气压[WMD=7.98,95%CI(7.22,8.73),P<0.001]、训练前后最大吸气压差值[WMD=5.76,95%CI(4.23,7.29),P<0.001]、动脉氧分压[WMD=9.55,95%CI(4.00,15.10),P<0.001]和动脉血氧饱和度[WMD=2.00,95%CI(1.15,2.85),P<0.001];缩短患者机械通气时间[SMD=-0.33,95%CI(-0.52,-0.14),P<0.001]、脱机时间[SMD=-1.00,95%CI(-1.51,-0.48),P<0.001]和ICU住院时间[WMD=-3.46,95%CI(-5.36,-1.56),P<0.001];并降低病死率[RR=0.55,95%CI(0.33,0.91),P=0.02],差异均具有统计学意义(P<0.05)。结论 吸气肌训练能有效改善机械通气患者最大吸气压,提高呼吸肌肌力与耐力,改善患者氧合状态,从而缩短机械通气时间、脱机时间和ICU住院时间,并降低病死率。

关键词: 吸气肌训练, 机械通气, 重症监护, 随机对照试验, Meta分析