| Objective:This study mainly used meta-analysis(Meta analysis)to evaluate the clinical efficacy of glucocorticoid(GC)in the prevention of bronchopulmonary dysplasia(BPD)in premature infants,mainly for its safety and effectiveness Analysis of related complications and corticosteroids provide a reliable basis for clinical prevention of BPD in premature infants.Methods:Search various literature databases by computer: Chinese literature databases:including Wanfang,China National Knowledge Internet(CNKI),VIP and China Biology Medicine Literature Database(CBM),etc.;English literature Database:Including Pub Med,Embase,Cochrane Library,as well as Chinese and foreign clinical trial registration centers,and manual retrieval is used to collect as much as possible and comprehensively all the glucocorticoid treatments for bronchopulmonary development in premature infants from the establishment of the database to December 2020 Bad randomized controlled trial(Randomized Controlled Trial,RCT)literature;then all the literature retrieved from each database is imported into the Endnote X9 literature management software,and duplicate literature,reviews,systematic reviews,animal experiments,comments,and failures are eliminated Obtain the full text of the literature;then carefully select the remaining documents in strict accordance with the inclusion and exclusion criteria formulated by this research;after the screening is completed,the remaining documents will be made into a table with the help of an Excel worksheet,and the general information and various items in each document will be Data extraction,and statistics.Use the Cochrane quality risk assessment tool to evaluate the quality of the research from seven aspects in turn on the data of the included literature.After the quality assessment is completed,use the Review Manager 5.2 software to perform statistical analysis,and make the corresponding forest map,and the combined effect size of each outcome indicator and its 95% confidence interval(95% Confidence Interval,95% CI)can be obtained.Finally,with the help of Stata 15.0 software,the corresponding funnel chart is produced,and the publication bias is evaluated to draw a conclusion.Results:Through a comprehensive search of Chinese and English databases and Chinese and foreign clinical trial registration centers,a total of 896 documents were retrieved.Among them,the number of Chinese documents accounted for 351 articles,and the number of English documents accounted for 545 articles.After a series of screening and exclusion,finally Twelve randomized controlled trials were included in this study,including a total of 1965 children(979 in the control group and 986 in the experimental group).Among the 12 documents included this time,7 documents clearly stated that the random number table method was used;2 documents described the method of allocation concealment,and all the documents did not mention loss to follow-up and other sources of bias,etc.Happening.Statistics and analysis of the outcome indicators involved in this study are carried out:(1)The main outcome indicators are the incidence of BPD and the fatality rate.Meta-analysis of various data can be drawn: the experimental group and the control group are preventing the incidence of BPD [RR=0.61,95%CI(0.53,0.70),P < 0.00001],case fatality rate[RR=0.57,95%CI(0.46,0.71),P < 0.00001] The differences are statistically significant,which means that sugar Corticosteroids can reduce the incidence and mortality of BPD in the prevention of BPD in premature infants;(2)The secondary outcome indicators are related complications,including ROP,NEC,IVH,PVL,PDA,pneumothorax,mechanical ventilation time,and oxygen inhalation time,Hospitalization time.Similarly,a Meta-analysis of various data can be obtained: the related complications of the experimental group and the control group ROP [RR=0.95,95%CI(0.84,1.09),P=0.48],NEC [RR=0.79,95% CI(0.58,1.08),P=0.14],IVH[RR=0.99,95%CI(0.81,1.21),P=0.90],PVL[RR=1.04,95%CI(0.46,2.34),P=0.92 ],pneumothorax [RR=1.55,95%CI(0.59,4.07),P=0.38] There is no statistically significant difference in the incidence of pneumothorax,which means that glucocorticoids in the application of BPD in premature infants have an effect on ROP,NEC,IVH,PVL There is no significant impact on the occurrence of related complications such as pneumothorax;there is a statistically significant difference in the incidence of PDA [RR=0.83,95%CI(0.73,0.95),P=0.006],which means that glucocorticoids are used in premature infants with BPD.In application,it can reduce the occurrence of PDA.In mechanical ventilation time [MD=-2.63,95%CI(-3.12,-2.14),P<0.00001],oxygen time [MD=-4.74,95%CI(-6.27,-3.20),P<0.00001] The difference is statistically significant,which means that the application of corticosteroids in premature infants with BPD can shorten the time of mechanical ventilation and oxygen inhalation;length of hospital stay [MD=-0.94,95%CI(-2.96,1.08),P =0.36] The difference was not statistically significant,which means that the application of glucocorticoids in premature infants with BPD cannot shorten the length of hospital stay.Conclusion:Meta-analysis of the data of the included 12 RCT studies shows that glucocorticoids can reduce the incidence and mortality of BPD in premature infants,and can reduce the incidence of PDA complications,and Without increasing the incidence of other related complications,such as ROP,NEC,IVH,PVL,and pneumothorax,it can also shorten the time of mechanical ventilation and oxygen inhalation in children,but it has no effect on the length of hospitalization.However,due to the small number of included literature,the small sample size,and the existence of publication bias,it may have a certain impact on the results of this study.In the future,more literature and a larger sample size are needed to eliminate bias in order to draw reliable conclusions. |
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