Fiberoptic bronchoscopy for stroke-associated pneumonia: a meta-analysis_West China Medical Journal

Authors：

ZHANG Yang ^1,2 , HUA Tianfeng ^1,2 , ZHENG Yao ^1,2 , LI Hui ^1,2 ,  YANG Min ^1,2

1. The Second Department of Intensive Care Unit, No. 2 Hospital Affiliated to Anhui Medical University, Hefei, Anhui 230601, P. R. China;
2. The Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, P. R. China;

Corresponding author：

YANG Min, Email: 512130761@qq.com

Keywords：

Fiberoptic bronchoscopy; Stroke-associated pneumonia; Meta-analysis

DOI：

10.7507/1002-0179.201901045

Video：

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ObjectiveTo systematically evaluate the efficacy of fiberoptic bronchoscopy for patients with stroke-associated pneumonia (SAP).MethodsAll randomized controlled trials on fiberoptic bronchoscopy in treating SAP were collected from Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, Chinese Biology Medicine database, Wanfang database, and Chongqing VIP database. Two reviewers screened the literature, extracted data, and assessed the methodological quality of included studies. And then meta-analysis was conducted using RevMan 5.3 software.ResultsTwelve studies with 1 107 patients were included. Compared with the routine therapy, the fiberoptic bronchoscopy combined with routine therapy showed a better efficacy [relative risk (RR)=1.26, 95% confidence interval (CI) (1.17, 1.36), P<0.000 01], and indicated a shorter hospital-stay [mean difference (MD)=–4.29 days, 95%CI (–5.06, –3.52) days, P<0.000 01] and lower Clinical Pulmonary Infection Score values [MD=–1.13, 95%CI (–1.77, –0.49), P=0.000 5]. Meanwhile, a downward trend in the level of procalcitonin [standardized mean difference (SMD)=–3.86, 95%CI (–4.22, –3.50), P<0.000 01], tumor necrosis factor α [SMD=–2.75, 95%CI (–3.84, –1.66), P<0.000 01], and C-reactive protein [SMD=–2.55, 95%CI (–3.83, –1.26), P=0.000 1], as well as a higher level of partial pressure of oxygen in arterial blood [MD=15.34 mm Hg (1 mm Hg=0.133 kPa), 95%CI (6.38, 24.31) mm Hg, P=0.000 8] appeared after the combined treatment.ConclusionBased on the conventional therapy, the treatment of fiberoptic bronchoscopy can improve the efficacy, shorten the hospital stay, relieve the systemic inflammatory responses, and improve the oxygenation of SAP patients.

Citation： ZHANG Yang, HUA Tianfeng, ZHENG Yao, LI Hui, YANG Min. Fiberoptic bronchoscopy for stroke-associated pneumonia: a meta-analysis. West China Medical Journal, 2019, 34(1): 66-73. doi: 10.7507/1002-0179.201901045 Copy

1.	Hilker R, Poetter C, Findeisen N, et al. Nosocomial pneumonia after acute stroke: implications for neurological intensive care medicine. Stroke, 2003, 34(4): 975-981.
2.	卒中相关性肺炎诊治中国专家共识组. 卒中相关性肺炎诊治中国专家共识. 中华内科杂志, 2010, 49(12): 1075-1078.
3.	韩秋, 李靖, 沈军, 等. 床旁纤支镜辅助治疗老年卒中相关性肺炎的研究. 临床肺科杂志, 2016(3): 450-452.
4.	刘鸿儒. 气管镜联合氨溴索雾化吸入治疗卒中相关性肺炎的临床分析. 临床医学研究与实践, 2017, 2(12): 17-18.
5.	张群, 李瑞萍, 郭辉, 等. 气管镜联合氨溴索治疗卒中相关性肺炎的临床分析. 临床医药文献电子杂志, 2017, 4(39): 7702-7703.
6.	郭宏杰. 气管镜联合氨溴索治疗卒中相关性肺炎的临床研究. 社区医学杂志, 2016, 14(2): 19-21.
7.	安晓洁, 乜庆荣, 邓赶飞, 等. 纤维支气管镜肺泡灌洗治疗社区获得性卒中相关性肺炎疗效观察. 新乡医学院学报, 2014, 31(5): 368-370.
8.	张遂甫, 段冲亚, 连广学, 等. 纤支镜联合氨溴索肺泡灌洗在老年卒中相关性肺炎中的应用. 社区医学杂志, 2017, 15(19): 16-18, 21.
9.	凌涛, 黄聃, 孙大勇. 便携式纤支镜肺泡灌洗辅助治疗重症卒中相关性肺炎的研究. 岭南急诊医学杂志, 2017, 22(3): 234-236.
10.	李丽荣, 曾祥毅, 巫剑峰, 等. 早期床旁纤维支气管镜吸痰及肺泡灌洗在卒中相关性肺炎患者中的应用. 临床医学, 2012, 32(6): 4-6.
11.	宋学红, 陈建霞. 支气管镜吸痰治疗卒中相关性肺炎的临床观察. 中国急救医学, 2017, 37(11): 212-213.
12.	许名远, 钟林清, 龚振斌, 等. 床旁纤支镜吸痰及肺泡灌洗在老年卒中相关性肺炎治疗中的效果观察. 中外医学研究, 2016, 14(36): 13-14.
13.	唐璐, 张智博, 彭旭. 纤维支气管镜肺泡灌洗吸痰术治疗卒中相关性肺炎的有效性分析. 延边医学, 2014, 25: 49-51.
14.	曹玉芝. 支气管肺泡灌洗术辅助治疗卒中相关性肺炎的临床分析. 中国医师进修杂志, 2014, 37(16): 68-69.
15.	Hsia DW, Tanner NT, Shamblin C, et al. The latest generation in flexible bronchoscopes: a description and evaluation. J Bronchology Interv Pulmonol, 2013, 20(4): 357-362.
16.	Thakkar MS, von Groote-Bidlingmaier F, Bolliger CT. Recent advances in therapeutic bronchoscopy. Swiss Med Wkly, 2012, 142(142): w13591.
17.	邓星奇, 李艳艳, 顾薇, 等. 临床肺部感染评分在卒中相关性肺炎患者预后评估中的作用. 蚌埠医学院学报, 2014, 39(2): 198-201.

1. Hilker R, Poetter C, Findeisen N, et al. Nosocomial pneumonia after acute stroke: implications for neurological intensive care medicine. Stroke, 2003, 34(4): 975-981.
2. 卒中相关性肺炎诊治中国专家共识组. 卒中相关性肺炎诊治中国专家共识. 中华内科杂志, 2010, 49(12): 1075-1078.
3. 韩秋, 李靖, 沈军, 等. 床旁纤支镜辅助治疗老年卒中相关性肺炎的研究. 临床肺科杂志, 2016(3): 450-452.
4. 刘鸿儒. 气管镜联合氨溴索雾化吸入治疗卒中相关性肺炎的临床分析. 临床医学研究与实践, 2017, 2(12): 17-18.
5. 张群, 李瑞萍, 郭辉, 等. 气管镜联合氨溴索治疗卒中相关性肺炎的临床分析. 临床医药文献电子杂志, 2017, 4(39): 7702-7703.
6. 郭宏杰. 气管镜联合氨溴索治疗卒中相关性肺炎的临床研究. 社区医学杂志, 2016, 14(2): 19-21.
7. 安晓洁, 乜庆荣, 邓赶飞, 等. 纤维支气管镜肺泡灌洗治疗社区获得性卒中相关性肺炎疗效观察. 新乡医学院学报, 2014, 31(5): 368-370.
8. 张遂甫, 段冲亚, 连广学, 等. 纤支镜联合氨溴索肺泡灌洗在老年卒中相关性肺炎中的应用. 社区医学杂志, 2017, 15(19): 16-18, 21.
9. 凌涛, 黄聃, 孙大勇. 便携式纤支镜肺泡灌洗辅助治疗重症卒中相关性肺炎的研究. 岭南急诊医学杂志, 2017, 22(3): 234-236.
10. 李丽荣, 曾祥毅, 巫剑峰, 等. 早期床旁纤维支气管镜吸痰及肺泡灌洗在卒中相关性肺炎患者中的应用. 临床医学, 2012, 32(6): 4-6.
11. 宋学红, 陈建霞. 支气管镜吸痰治疗卒中相关性肺炎的临床观察. 中国急救医学, 2017, 37(11): 212-213.
12. 许名远, 钟林清, 龚振斌, 等. 床旁纤支镜吸痰及肺泡灌洗在老年卒中相关性肺炎治疗中的效果观察. 中外医学研究, 2016, 14(36): 13-14.
13. 唐璐, 张智博, 彭旭. 纤维支气管镜肺泡灌洗吸痰术治疗卒中相关性肺炎的有效性分析. 延边医学, 2014, 25: 49-51.
14. 曹玉芝. 支气管肺泡灌洗术辅助治疗卒中相关性肺炎的临床分析. 中国医师进修杂志, 2014, 37(16): 68-69.
15. Hsia DW, Tanner NT, Shamblin C, et al. The latest generation in flexible bronchoscopes: a description and evaluation. J Bronchology Interv Pulmonol, 2013, 20(4): 357-362.
16. Thakkar MS, von Groote-Bidlingmaier F, Bolliger CT. Recent advances in therapeutic bronchoscopy. Swiss Med Wkly, 2012, 142(142): w13591.
17. 邓星奇, 李艳艳, 顾薇, 等. 临床肺部感染评分在卒中相关性肺炎患者预后评估中的作用. 蚌埠医学院学报, 2014, 39(2): 198-201.

West China Medical Journal

Fiberoptic bronchoscopy for stroke-associated pneumonia: a meta-analysis

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