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To determine the efficacy of long-term noninvasive positive pressure ventilation (NPPV) on stable chronic obstructive pulmonary disease (COPD). Information was collected from the database of China National Knowledge Infrastructure (CNKI), WanFang, WeiPu, PubMed, EMbase, CBM (from the begining to October 2014). Statistical analysis was performed with the Cochrane Collaboration's software RevMan 5.2. A total of 23 trials involving 1 200 patients were included. RESULTS showed that NPPV can reduce PaCO2 and improve PaO2 in patients with stable COPD; two years of NPPV can delay the decline in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), increase six-minutes walk distance (6MWD) and reduce mortality in patients with stable COPD (OR=0.62, 95% CI 0.47 to 0.82). NPPV can improve the arterial blood gas in patients, and the longer the application of NPPV, the better effect; NPPV can increase exercise endurance and improve the quality of life for the patients; long application of NPPV can delay the decline in FEV1and FVC (2 years or longer); NPPV can reduce the mortality of COPD patients.目的：系统评价长期无创正压通气(noninvasive positive pressure ventilation，NPPV)治疗重度慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)稳定期患者的效果。方法：检索中国期刊全文数据库、万方、维普、中国生物医学文献数据库以及PubMed，EMbase等，检索时间均为从建库至2014年10月，纳入NPPV治疗重度稳定期COPD患者的所有随机对照试验(randomized controlled trial，RCT)，并逐个进行质量评价和资料提取，统计学分析采用RevMan 5.2软件处理。结果：共纳入23个RCT，1 200例患者。Meta分析结果显示与对照组相比，NPPV治疗组患者PaCO2降低、PaO2升高；肺功能下降延缓；患者6 min步行距离增加；患者的病死率降低(OR=0.62，95% CI: 0.47~0.82)。结论：NPPV可改善患者动脉血气，且应用NPPV时间越长，效果越明显；可增加患者的运动耐力，改善生活质量；长时间治疗(≥2年)可延缓患者肺功能下降，降低患者病死率。. |
