目的:为了检查结果,证据水平,关于外科口罩在减少病毒性呼吸道疾病传播方面的有效性的原始研究的方法学质量,and,特别是,N95呼吸器与外科口罩的性能。
方法:根据使用PubMed的系统评价和荟萃分析(PRISMA)指南的首选报告项目进行荟萃分析,MEDLINE,和Cochrane图书馆数据库.
结果:在筛选153篇文章后,纳入了8项研究(9164名参与者)。分析显示,使用N95呼吸器与外科口罩预防流感样疾病的差异具有统计学意义(风险比[RR]=0.81,95%置信区间[CI]=0.68-0.94,P<0.05),非流感呼吸道病毒感染(RR=0.62,95%CI=0.52-0.74,P<0.05),呼吸道病毒感染(RR=0.73,95%CI=0.65-0.82,P<0.05),严重急性呼吸综合征冠状病毒(SARS-CoV)1和2病毒感染(RR=0.17,95%CI=0.06-0.49,P<0.05),和实验室确认的呼吸道病毒感染(RR=0.75,95%CI=0.66-0.84,P<0.05)。分析结果与实验室确诊的流感没有统计学意义(RR=0.87,CI=0.74-1.03,P>0.05)。
结论:与外科口罩相比,使用N95呼吸器的医护人员的病毒感染发作较少。与本调查中包括的其他病毒相比,N95呼吸器在降低SARS-CoV1和2病毒在医院环境中病毒感染的风险方面最有效。方法学质量,偏见的风险,少量的原始研究表明有必要进行进一步的研究,尤其是在一线医疗服务中。
OBJECTIVE: To examine the results, level of evidence, and methodologic quality of original studies regarding surgical mask effectiveness in minimizing viral respiratory illness transmission, and, in particular, the performance of the N95 respirator versus surgical mask.
METHODS: Meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with use of PubMed, MEDLINE, and the Cochrane Library databases.
RESULTS: Eight studies (9164 participants) were included after screening 153 articles. Analyses showed statistically significant differences between N95 respirator versus surgical mask use to prevent influenza-like-illness (risk ratio [RR] = 0.81, 95% confidence interval [CI] = 0.68-0.94, P < 0.05), non-influenza respiratory viral infection (RR = 0.62, 95% CI = 0.52-0.74, P < 0.05), respiratory viral infection (RR = 0.73, 95% CI = 0.65-0.82, P < 0.05), severe acute respiratory syndrome coronavirus (SARS-CoV) 1 and 2 virus infection (RR = 0.17, 95% CI = 0.06-0.49, P < 0.05), and laboratory-confirmed respiratory viral infection (RR = 0.75, 95% CI = 0.66-0.84, P < 0.05). Analyses did not indicate statistically significant results against laboratory-confirmed influenza (RR = 0.87, CI = 0.74-1.03, P > 0.05).
CONCLUSIONS: N95 respirator use was associated with fewer viral infectious episodes for healthcare workers compared with surgical masks. The N95 respirator was most effective in reducing the risk of a viral infection in the hospital setting from the SARS-CoV 1 and 2 viruses compared to the other viruses included in this investigation. Methodologic quality, risk of biases, and small number of original studies indicate the necessity for further research to be performed, especially in front-line healthcare delivery settings.