高频振荡通气治疗急性呼吸窘迫综合征安全性及有效性的荟萃分析

柳舟; 张亮; 李光; 侯彦广; 陈倩倩; 彭卫; 杨巧玉; 詹丽英

doi:10.14188/j.1671-8852.2024.0746

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高频振荡通气治疗急性呼吸窘迫综合征安全性及有效性的荟萃分析

综述与Meta分析 | 更新时间：2026-11-05

- 高频振荡通气治疗急性呼吸窘迫综合征安全性及有效性的荟萃分析
- Safety and effectiveness of high⁃frequency oscillatory ventilation for the treatment of acute respiratory distress syndrome: A meta⁃analysis
- 武汉大学学报（医学版） 2025年46卷第11期页码：1513-1522
- 作者机构：
  
  1.武汉大学人民医院，重症医学科，湖北武汉 430060
  2.武汉大学人民医院，放射科，湖北武汉 430060
  3.宜昌市中心人民医院呼吸与危重医学科湖北宜昌 443003
- 作者简介：
  
  柳舟，女，1988—，医学博士生，主要从事急性呼吸窘迫综合征相关的基础及临床研究，E⁃mail: 992859638@qq.com
  詹丽英，女，1971—，主任医师，博士生导师，主要从事脓毒症的基础及临床研究，E⁃mail:2582062108@qq.com
- 基金信息：
  
  武汉市知识创新专项项目(2023020201010165);国家自然科学基金面上项目(82272226);武汉大学人民医院交叉创新人才项目(JCRCZN⁃2022⁃017;JCRCZN⁃2022⁃005)
- DOI：10.14188/j.1671-8852.2024.0746
  中图分类号： R563.8
- 收稿：2024-09-27，
  
  纸质出版：2025-11-25
- 稿件说明：
移动端阅览
柳舟,张亮,李光等.高频振荡通气治疗急性呼吸窘迫综合征安全性及有效性的荟萃分析[J].武汉大学学报（医学版）,2025,46(11):1513-1522.

LIU Zhou,ZHANG Liang,LI Guang,et al.Safety and effectiveness of high⁃frequency oscillatory ventilation for the treatment of acute respiratory distress syndrome: A meta⁃analysis[J].Medical Journal of Wuhan University,2025,46(11):1513-1522.
柳舟,张亮,李光等.高频振荡通气治疗急性呼吸窘迫综合征安全性及有效性的荟萃分析[J].武汉大学学报（医学版）,2025,46(11):1513-1522. DOI： 10.14188/j.1671-8852.2024.0746.

LIU Zhou,ZHANG Liang,LI Guang,et al.Safety and effectiveness of high⁃frequency oscillatory ventilation for the treatment of acute respiratory distress syndrome: A meta⁃analysis[J].Medical Journal of Wuhan University,2025,46(11):1513-1522. DOI： 10.14188/j.1671-8852.2024.0746.

摘要

目的

系统评价高频振荡通气（HFOV）与常规机械通气（CMV）治疗急性呼吸窘迫综合征（ARDS）患者的安全性及有效性。

方法

检索Pubmed、Embase、Cochrane Library、中国知网、中国生物医学文献数据库、万方数据库、维普数据库，查找所有比较HFOV与CMV治疗ARDS患者的临床研究，检索时间为建库至2024年7月31日。按照纳入及排除标准筛选文献并采用Revman 5.3软件进行Meta分析。

结果

最终纳入23篇、共计3 146例ARDS患者。安全性方面，HFOV组与CMV组治疗期间患者心率（

=0.300）、平均动脉压（

=0.170）

中心静脉压（

=0.180）和死亡率（

=0.160）均无明显差异，但HFOV组并发症风险更低（

=0.68

95%

:0.56~0.83

=0.002）。有效性方面，HFOV组与CMV治疗期间患者血气pH值（

=0.290）、平台压（

=0.230）、氧浓度（

=0.260）、总住院日（

=0.220）均无明显差异，但HFOV组患者机械通气时间更短（

SMD

=-0.85

95%

:-1.26~-0.45

0.001）；ICU住院日缩短（

SMD=

-1.05

95%

CI:

-1.27~-0.82

0.001）；氧分压更高（

SMD

=0.63

95%

:0.44~0.83

0.001）；二氧化碳分压更低（

SMD

=-0.47

95%

:-0.76~-0.19

=0.001）；氧合指数改善明显（

SMD

=0.82

95%

:0.59~1.05

0.001）。

结论

HFOV治疗ARDS的安全性及有效性较高，能够缩短ICU住院日，显著提升氧分压，降低二氧化碳分压并在改善氧合指数同时降低并发症风险。

Abstract

Objective

To review systematically the safety and effectiveness of high⁃frequency oscillatory ventilation (HFOV) compared to conventional mechanical ventilation (CMV) in the treatment of acute respiratory distress syndrome (ARDS).

Methods

All relevant randomised controlled trials comparing HFOV with CMV in ARDS patients were systematically searched in PubMed

Embase

The Cochrane Library

CNKI

CBM

WanFang

and VIP databases from inception to 31 July 2024. Studies were selected according to predefined inclusion and exclusion criteria

and meta⁃analysis was performed using RevMan 5.3.

Results

Twenty⁃three studies containing as many as 3 146 patients diagnosed with ARDS were included. In terms of safety

there was no significant difference in heart rate (

=0.300)

mean arterial pressure (

=0.170)

central venous pressure (

=0.180)

or even mortality (

=0.160) between HFOV and CMV groups. The incidence of complications in the HFOV group was lower than in the CMV group (

=0.68

95%

: 0.56⁃0.83

=0.002). In terms of effectiveness

there were no significant differences in pH values (

=0.290)

plateau pressure (

=0.230)

oxygen concentration (

=0.260)

and hospitalization days (

=0.220) between the two groups. In the HFOV group

the mechanical ventilation time (

SMD

=-0.85

95%

:-1.26⁃-0.45

0.001) and the ICU length of stay (

SMD

=-1.05

95%

:-1.27⁃-0.82

0.001) were shorter; oxygen partial

pressure was much higher (

SMD

=0.63

95%

:0.44⁃0.83

0.001); carbon dioxide pressure was lower (

SMD

=-0.47

95%

:-0.76⁃-0.19

=0.001) and oxygenation index improved significantly (

SMD

=0.82

95%

:0.59⁃1.05

0.001) as compared with that respectively in the CMV group.

Conclusion

HFOV is safe and effective in ARDS patients. It significantly shortens ICU length of stay

improves oxygenation index and PaO₂

reduces PaCO₂

and lowers the risk of complications.

关键词

Keywords

references

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