现在的位置: 首页时讯速递, 进展交流>正文
[JAMA发表论文]:医务人员佩戴N95口罩或医用口罩预防流感
2019年09月14日 时讯速递, 进展交流 暂无评论

Original Investigation September 3, 2019

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial

Lewis J. Radonovich Jr, Michael S. Simberkoff, Mary T. Bessesen, et al

JAMA. 2019;322(9):824-833. doi:10.1001/jama.2019.11645

Abstract

Importance 背景

Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections.

有关N95口罩和医用预防医务人员(HCP)在工作场所传染病毒性呼吸道感染的作用,临床研究结果并不一致

Objective 目的

To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP.

比较N95口罩与医用口罩预防HCP流感及其他病毒性呼吸道感染的效果。

Design, Setting, and Participants 设计,场景及研究对象

A cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups.

2011年9月至2015年5月,美国7个医学中心的137个门诊部进行了一项群组随机、实效性研究,最后随访日期为2016年6月。在为期4年的研究期间,每年病毒性呼吸道疾病最为流行的12周内,每个医学中心中的门诊部配对(群组)进行匹配,并随机分为N95口罩或医用口罩组。

Interventions 干预措施

Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness.

189个群组共计1993名受试者随机分至N95口罩组,即接近呼吸道疾病患者时佩戴N95口罩(2512个HCP观察季节),191个群组的2058名受试者随机分至医用口罩组(2668个HCP观察季节)。

Main Outcomes and Measures 主要预后指标

The primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed.

主要预后指标为实验室确诊的流感发病率。次要预后指标包括急性呼吸道疾病、实验室检测的呼吸道感染、实验室确诊的呼吸道疾病及流感样病例的发病率。我们对干预措施的依从性进行了评估。

Results 结果

Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, −0.5% to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, −21.9 per 1000 HCP-seasons [95% CI, −48.2 to 4.4]; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, −8.9 per 1000 HCP-seasons, [95% CI, −33.3 to 15.4]; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, −8.6 per 1000 HCP-seasons [95% CI, −28.2 to 10.9]; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, −11.3 per 1000 HCP-seasons [95% CI, −23.8 to 1.3]; P = .08). In the respirator group, 89.4% of participants reported “always” or “sometimes” wearing their assigned devices vs 90.2% in the mask group.

共有2862人接受随机分组(平均 [SD] 年龄,43 [11.5] 岁;2369 [82.8%] 名女性),其中2371人完成研究,共计5180个HCP季节。N95口罩组实验室确诊流感感染病例207例(HCP季节的8.2%),医用口罩组193例(HCP季节的7.2%)(差异1.0%,[95% CI, −0.5% to 2.5%]; P = .18)(校正比数比[OR],1.18 [95% CI, 0.95-1.45])。N95口罩组发生1556例急性呼吸道疾病,医用口罩组为1711例(差异,每1000个HCP季节−21.9例 [95% CI, −48.2 to 4.4]; P = .10);N95口罩组发生679例实验室检测的呼吸道感染,医用口罩组为745例(差异,每1000个HCP季节−8.9例,[95% CI, −33.3 to 15.4]; P = .47);N95口罩组发生实验室确诊的呼吸道疾病371例,医用口罩组 417 例(差异,每1000个HCP季节 −8.6 例 [95% CI, −28.2 to 10.9]; P = .39);N95口罩组发生流感样病例 128 例,医用口罩组 166 例(差异,每1000个HCP季节−11.3例 [95% CI, −23.8 to 1.3]; P = .08)。N95口罩组中,89.4%的受试者报告“总是”或“有时”佩戴N95口罩,医用口罩组为90.2%。

Conclusions and Relevance 结论和意义

Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.

本研究结果显示,在门诊部工作的医务人员佩戴N95口罩或医用口罩,不影响实验室确诊流感的发病率。

Trial Registration 试验注册

ClinicalTrials.gov Identifier: NCT01249625

给我留言

您必须 [ 登录 ] 才能发表留言!

×
腾讯微博