The Security And Efficacy Of Pulmonary Surfactant Combined With Budesonide Endotracheal Instillation For Preventing Bronchopulmonary Dysplasia:A Systemiatic Review And Meta-analysis

Objective: To review the security and efficacy of pulmonary surfactant combined with budesonide endotracheal instillation for preventing bronchopulmonary dysplasia(BPD)using meta-analysis methods.Methods: Related literatures were retrieved in Pub Med、the Cochrane Library、EMBASE、CNKI and Wanfang Database from establishment to November 2017.The incidence rate of BPD、the mortality of BPD were considered as the primary results,meanwhile,the rate of related complication were considered as the secondary results.The Cochrane handbook was used to evaluate methodological quality,Revman 5.3 software was used for meta-analysis and Egger’s test was used to evaluate publication bias.Results: Five RCTs(495 infants)were enrolled for meta-analysis,included 242 infants in the test group and 253 infants in the control group.Results of meta-analysis showed that the incidence of BPD was decreased in test group(RR=0.56,95%CI: 0.43-0.72,P<0.001),and the mortality of BPD was lower in test group(RR=0.64,95%CI:0.41-0.99,P<0.05).There was no significant difference in the incidence of intraventricular hemorrhage 、infection/sepsis、ROP、PDA、NEC、hyperglycemia、hypertension between test group and control group.Conclusion: Pulmonary surfactant combined with budesonide endotracheal instillation can decrease the incidence of BPD and the mortality of BPD without higher incidence of short-term complications.Because of limited quantity and quality of the trials enrolled in the study,large sample、multi-center clinical randomized controlled trials are needed to prove the security and efficacy of pulmonary surfactant combined with budesonide endotracheal instillation,furthermore,further evidences from RCTs are needed to evaluate the incidence of long-term complication.