目的：运用循证医学理论和方法，对选择性消化道去污染（SDD）预防呼吸机相关性肺炎（VAP）的效果进行 Meta 分析。方法计算机检索1995—2014年 PubMed、EMBASE、中国生物医学文献数据库 CBMdisc、中国学术期刊全文数据库 CNKI、维普中文生物医学期刊数据库，以及 Cochrane library （2014年第12期）共6个医学数据库，筛选文献，进行数据资料提取及质量评价，应用 RevMan 5．3软件进行统计分析。结果共纳入13篇文献（包含2676例患者），Meta 分析结果显示，治疗组和对照组 VAP 发病率分别为20．68％、35．99％，OR 及95％CI为0．40（0．28，0．56），两组比较差异有统计学意义（P ＜0．001）；治疗组和对照组机械通气患者病死率分别为20．60％、20．03％，OR 及95％CI 为0．99（0．81，1．20），两组比较差异无统计学意义（P ＝0．91）。结论 SDD 能降低机械通气患者 VAP 发病率，但尚不能认为 SDD 能降低机械通气患者病死率。%Objective To evaluate the effect of selective decontamination of digestive tract(SDD)on preventing ventilator-associated pneumonia by Meta-analysis based on theory and method of evidence-based medicine.Methods Six medical databases (PubMed,Excerpta Medica Database [EMBASE],China Biology Medicine disc[CBMdi-sc],China National Knowledge Infrastructure[CNKI],VIP database,from 1995 to 2014,and Cochrane Library of issue 12,2014 )were searched,literatures were selected,data were extracted,Meta-analysis was performed by using RevMan 5.3 software.Results 13 literatures were included (2 676 patients were involved),Meta-analysis revealed that the incidence of VAP in treatment and control group was 20.68% and 35.99% respectively (OR and 95%CI ,0.40 [0.28,0.56],P <0.001 ),the mortality rate of patients with mechanical ventilation in treatment group and control group were 20.60% and 20.03% respectively (OR and 95%CI ,0.99 [0.81 ,1 .20],P =0.91 ). Conclusion SDD can reduce the incidence of VAP in patients with mechanical ventilation,but can’t reduce mortali-ty rate.
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