中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2014年
3期
142-147
,共6页
莫嫣娉%胡小兰%常丽丽%马朋林
莫嫣娉%鬍小蘭%常麗麗%馬朋林
막언빙%호소란%상려려%마붕림
脓毒症%全身炎症反应综合征%ω-3多不饱和脂肪酸%随机对照临床试验%Meta分析
膿毒癥%全身炎癥反應綜閤徵%ω-3多不飽和脂肪痠%隨機對照臨床試驗%Meta分析
농독증%전신염증반응종합정%ω-3다불포화지방산%수궤대조림상시험%Meta분석
Sepsis%Systemic inflammatory response syndrome%ω-3 polyunsaturated fatty acids%Randomized controlled trial%Meta-analysis
目的 评价肠外营养(PN)中添加ω-3多不饱和脂肪酸对脓毒症患者预后的影响.方法 通过计算机检索MEDLINE、EMBASE、Cochrane Library、中国知网CNKI和万方生物医学期刊全文数据库(1996年1月至2013年6月),全面收集有关PN中添加ω-3多不饱和脂肪酸治疗脓毒症患者的随机对照临床试验(RCT)文章,并进行质量评估.治疗组为PN中添加ω-3多不饱和脂肪酸,对照组为常规PN治疗.应用RevMan 5.0软件进行统计学分析.结果 共纳入12篇RCT、721例患者.结果显示:PN中添加ω-3多不饱和脂肪酸可以降低脓毒症患者28 d病死率[相对危险度(RR)=0.77,95％可信区间(95％CI)为0.59～ 0.99,P=0.04],缩短重症监护病房(ICU)住院时间[加权均数差(WMD) =-3.10,95％CI为-5.98 ～-0.21,P=0.04]及总住院时间(WMD=-3.12,95％CI为-4.65 ～-1.60,P＜0.000 1),但不能缩短机械通气时间(WMD=1.33,95％CI为-5.09～7.75,P=0.69).结论 本荟萃分析(Meta分析)显示,PN中添加ω-3多不饱和脂肪酸能改善脓毒症患者临床预后,但由于纳入文献质量大多较低,须谨慎看待此Meta分析结果.
目的 評價腸外營養(PN)中添加ω-3多不飽和脂肪痠對膿毒癥患者預後的影響.方法 通過計算機檢索MEDLINE、EMBASE、Cochrane Library、中國知網CNKI和萬方生物醫學期刊全文數據庫(1996年1月至2013年6月),全麵收集有關PN中添加ω-3多不飽和脂肪痠治療膿毒癥患者的隨機對照臨床試驗(RCT)文章,併進行質量評估.治療組為PN中添加ω-3多不飽和脂肪痠,對照組為常規PN治療.應用RevMan 5.0軟件進行統計學分析.結果 共納入12篇RCT、721例患者.結果顯示:PN中添加ω-3多不飽和脂肪痠可以降低膿毒癥患者28 d病死率[相對危險度(RR)=0.77,95％可信區間(95％CI)為0.59～ 0.99,P=0.04],縮短重癥鑑護病房(ICU)住院時間[加權均數差(WMD) =-3.10,95％CI為-5.98 ～-0.21,P=0.04]及總住院時間(WMD=-3.12,95％CI為-4.65 ～-1.60,P＜0.000 1),但不能縮短機械通氣時間(WMD=1.33,95％CI為-5.09～7.75,P=0.69).結論 本薈萃分析(Meta分析)顯示,PN中添加ω-3多不飽和脂肪痠能改善膿毒癥患者臨床預後,但由于納入文獻質量大多較低,鬚謹慎看待此Meta分析結果.
목적 평개장외영양(PN)중첨가ω-3다불포화지방산대농독증환자예후적영향.방법 통과계산궤검색MEDLINE、EMBASE、Cochrane Library、중국지망CNKI화만방생물의학기간전문수거고(1996년1월지2013년6월),전면수집유관PN중첨가ω-3다불포화지방산치료농독증환자적수궤대조림상시험(RCT)문장,병진행질량평고.치료조위PN중첨가ω-3다불포화지방산,대조조위상규PN치료.응용RevMan 5.0연건진행통계학분석.결과 공납입12편RCT、721례환자.결과현시:PN중첨가ω-3다불포화지방산가이강저농독증환자28 d병사솔[상대위험도(RR)=0.77,95％가신구간(95％CI)위0.59～ 0.99,P=0.04],축단중증감호병방(ICU)주원시간[가권균수차(WMD) =-3.10,95％CI위-5.98 ～-0.21,P=0.04]급총주원시간(WMD=-3.12,95％CI위-4.65 ～-1.60,P＜0.000 1),단불능축단궤계통기시간(WMD=1.33,95％CI위-5.09～7.75,P=0.69).결론 본회췌분석(Meta분석)현시,PN중첨가ω-3다불포화지방산능개선농독증환자림상예후,단유우납입문헌질량대다교저,수근신간대차Meta분석결과.
Objective To determine whether the supplementation of ω-3 polyunsaturated fatty acids in parenteral nutrition (PN) confers treatment benefits to outcomes of septic patients.Methods The databases of MEDLINE,EMBASE,Cochrane central register of controlled trials,the CNKI and the Wanfang biomedicine were searched to identify prospective randomized controlled trials (RCTs) which compared the ω-3 polyunsaturated fatty acids supplemented with the standard PN on outcomes of adult patients with sepsis from January 1996 to June 2013.The methodological quality of the included studies was evaluated,and the Cochrane Collaboration RevMan 5.0 was used for data analysis.Results A total of 12 studies enrolling 721 patients were included.Significant reduction in 28-day mortality [relative risk (RR) 0.77,95％ confidence interval (95％CI) 0.59 to 0.99,P=0.04],short intensive care unit [ICU,weighted mean difference (WMD)=-3.10,95％CI-5.98 to-0.21,P=0.04] and hospital length of stay (WMD =-3.12,95％CI-4.65 to-1.60,P＜0.000 1) were observed in patients receiving ω-3 polyunsaturated fatty acids supplemented PN.There was no differences in days of mechanical ventilation between patients with or without adding ω-3 polyunsaturated fatty acids in PN (WMD =1.33,95％ CI-5.09 to 7.75,P=0.69).Conclusions Meta-analysis results demonstrated that PN supplemented with ω-3 polyunsaturated fatty acids was beneficial in improving the outcomes of patients with sepsis.However,this conclusion must be interpreted with caution due to the low quality of the enrolled trials.
