系统评价雾化吸入肝素在吸入性损伤患者中的疗效与安全性。

检索PubMed、Embase、Cochrane Library、中国知网（CNKI）及万方数据知识服务平台中采用雾化吸入肝素治疗吸入性损伤的相关文献，检索时限从建库至2025年9月1日。由2名研究者独立完成文献筛选、数据提取及偏倚风险评估。采用RevMan 5.4软件进行荟萃分析。

共纳入11项研究，共计710例吸入性损伤患者。荟萃分析结果显示，与常规治疗相比，雾化吸入肝素可降低患者28 d病死率（RR=0.74，95%CI：0.59~0.92，P=0.008），缩短机械通气持续时间（MD=-3.86，95%CI：-5.71~-2.01，P<0.001）；仅纳入2项研究（238例患者）的合并结果显示，雾化吸入肝素可改善患者氧合指数（MD=18.07，95%CI：12.51~23.64，P<0.001）。在安全性方面，雾化吸入肝素治疗患者与常规治疗患者相比，肺炎发生率差异无统计学意义（RR=0.95，95%CI：0.68~1.32，P=0.76）；仅纳入3项研究（223例患者）的合并结果显示，2种方法治疗患者出血事件发生率差异无统计学意义（RR=1.02，95%CI：0.82~1.27，P=0.87）。

吸入性损伤患者早期采用以雾化吸入肝素为核心的联合治疗方案，有助于降低28 d病死率，缩短机械通气持续时间，且未增加肺炎发生风险，具有较好的安全性。

To systematically evaluate the efficacy and safety of nebulized heparin in patients with inhalation injury.

A systematic search was conducted in PubMed，Embase，the Cochrane Library，the China National Knowledge Infrastructure （CNKI），and the Wanfang Data Knowledge Service Platform for literatures about the use of nebulized heparin in patients with inhalation injury published from database inception to September 1，2025. Two reviewers independently conducted literature screening，data extraction，and risk of bias assessment. Meta-analysis was performed using RevMan 5.4 software.

A total of 11 studies involving 710 patients with inhalation injury were included. Meta-analysis results showed that，compared with conventional treatment，nebulized heparin reduced 28-day mortality （RR=0.74，95%CI：0.59 to 0.92，P=0.008），shortened the duration of mechanical ventilation （MD=-3.86，95%CI： -5.71 to -2.01，P<0.001）. The pooled result of only 2 studies （238 patients） showed that nebulized heparin could improve the oxygenation index （MD=18.07，95%CI： 12.51 to 23.64，P<0.001）. In terms of safety，there was no statistically significant difference in the incidence of pneumonia between patients receiving nebulized heparin therapy and those receiving conventional treatment （RR=0.95，95%CI： 0.68 to 1.32，P=0.76）. The pooled result of only 3 studies （223 patients） showed no statistically significant difference in the incidence of bleeding events between patients treated with the two methods （RR=1.02，95%CI： 0.82 to 1.27，P=0.87）.

Early initiation of a combination regimen centered on nebulized heparin in patients with inhalation injury may help reduce 28-day mortality and shorten the duration of mechanical ventilation, without increasing the risk of pneumonia，indicating a favorable safety profile.