新型脂肪乳劑（SMOFlipid）應(yīng)用于早產(chǎn)兒腸外營養(yǎng)的系統(tǒng)評(píng)價(jià)：隨機(jī)對(duì)照試驗(yàn)的meta分析
發(fā)布時(shí)間：2019-05-17 05:04
【摘要】：目的：系統(tǒng)評(píng)價(jià)早產(chǎn)兒輸注SMOFlipid脂肪乳劑(含大豆油30%、中鏈甘油三酯30%、橄欖油25%和魚油15%)的安全性和有效性。 方法：計(jì)算機(jī)檢索PUBMED, EMBASE, Cochrane數(shù)據(jù)庫,中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM),中國知網(wǎng)(CNKI),檢索時(shí)間均從建庫至2014年1月。剔除重復(fù)文獻(xiàn)后,根據(jù)題名及摘要篩查文獻(xiàn),符合要求的文獻(xiàn)獲取全文進(jìn)一步篩查,納入SMOFlipid脂肪乳劑應(yīng)用于早產(chǎn)兒腸外營養(yǎng)的所有隨機(jī)對(duì)照試驗(yàn)(RCTs)。按照Cochrane協(xié)作網(wǎng)系統(tǒng)評(píng)價(jià)方法,評(píng)價(jià)納入研究的質(zhì)量并提取研究資料。使用Revman5.2軟件對(duì)提取的數(shù)據(jù)進(jìn)行分析,檢驗(yàn)異質(zhì)性,并根據(jù)異質(zhì)性結(jié)果選擇相應(yīng)的效應(yīng)模型。最后采用GRADE系統(tǒng)對(duì)證據(jù)質(zhì)量進(jìn)行評(píng)價(jià)。 結(jié)果：經(jīng)過對(duì)287篇文獻(xiàn)進(jìn)行篩選后,最終納入6項(xiàng)隨機(jī)對(duì)照試驗(yàn),總共有323例患兒符合納入標(biāo)準(zhǔn),其中實(shí)驗(yàn)組160例,對(duì)照組163例。SMOFlipid組與Intralipid組相比,患兒恢復(fù)出生體重時(shí)間、第1周體重增長(zhǎng)率、死亡率、住院時(shí)間、機(jī)械通氣時(shí)間、氧療時(shí)間、膽汁淤積癥發(fā)病率、敗血癥發(fā)病率、BPD(支氣管肺發(fā)育不良)發(fā)病率、NEC(壞死性小腸結(jié)腸炎)發(fā)病率、嚴(yán)重不良事件發(fā)生率等均無顯著性差異,而在ROP(早產(chǎn)兒視網(wǎng)膜病)的發(fā)病率上,SMOFlipid組顯著低于Intralipid組。SMOFlipid組與Clinoleic組相比,患兒死亡率、BPD發(fā)病率均無顯著性差異。所有結(jié)局指標(biāo)根據(jù)GRADE系統(tǒng)質(zhì)量分級(jí)均為中等質(zhì)量或低質(zhì)量。 結(jié)論：早產(chǎn)兒輸注SMOFlipid是安全、有效的,相同劑量的SMOFlipid與傳統(tǒng)脂肪乳提供的熱卡相當(dāng),均可滿足早產(chǎn)兒生后早期生長(zhǎng)發(fā)育的能量需求。與傳統(tǒng)脂肪乳劑相比,應(yīng)用SMOFlipid可降低ROP的發(fā)病率,但其他臨床結(jié)局無顯著性差異。根據(jù)GRADE系統(tǒng)的證據(jù)質(zhì)量評(píng)級(jí)顯示大部分證據(jù)質(zhì)量為中等質(zhì)量或低質(zhì)量。
[Abstract]:Objective: to evaluate the safety and efficacy of SMOFlipid fat emulsion (including soybean oil 30%, medium chain TG 30%, olive oil 25% and fish oil 15%) in premature infants. Methods: the PUBMED, EMBASE, Cochrane database was searched by computer, and the (CNKI), retrieval time of China knowledge Network (CBM),) was from the establishment of the database to January 2014. After eliminating the duplicate literature, according to the title and abstract screening literature, the full text of the literature was further screened, and all randomized controlled trials of SMOFlipid fat emulsion used in parenteral nutrition of premature infants were included in (RCTs). According to the Cochrane collaborative network system evaluation method, the quality of the research was evaluated and the research data were extracted. The extracted data are analyzed by Revman5.2 software, the heterogeneity is tested, and the corresponding effect model is selected according to the heterogeneity results. Finally, GRADE system is used to evaluate the quality of evidence. Results: after screening 287 articles, a total of 323 children met the inclusion criteria, including 160 in the experimental group and 163 in the control group. Compared with the Intralipid group, the children in the control group recovered birth weight. In the first week, body weight growth rate, mortality, hospitalization time, mechanical ventilation time, oxygen therapy time, incidence of cholestasis, incidence of septicemia, incidence of, BPD (bronchopnea), incidence of, NEC (necrotizing enterocolitis), There was no significant difference in the incidence of severe adverse events, but the incidence of ROP in SMOFlipid group was significantly lower than that in Intralipid group. Compared with Clinoleic group, there was no significant difference in mortality and BPD incidence between MOFlipid group and MOFlipid group. All outcome indexes were classified as medium quality or low quality according to the quality of GRADE system. Conclusion: SMOFlipid infusion in premature infants is safe and effective. The same dose of SMOFlipid is similar to the calorie provided by traditional fat milk, which can meet the energy needs of early growth and development of premature infants. Compared with traditional fat emulsion, SMOFlipid could reduce the incidence of ROP, but there was no significant difference in other clinical outcomes. According to the evidence quality rating of GRADE system, most of the evidence quality is medium quality or low quality.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R722.6
本文編號(hào)：2478824
[Abstract]:Objective: to evaluate the safety and efficacy of SMOFlipid fat emulsion (including soybean oil 30%, medium chain TG 30%, olive oil 25% and fish oil 15%) in premature infants. Methods: the PUBMED, EMBASE, Cochrane database was searched by computer, and the (CNKI), retrieval time of China knowledge Network (CBM),) was from the establishment of the database to January 2014. After eliminating the duplicate literature, according to the title and abstract screening literature, the full text of the literature was further screened, and all randomized controlled trials of SMOFlipid fat emulsion used in parenteral nutrition of premature infants were included in (RCTs). According to the Cochrane collaborative network system evaluation method, the quality of the research was evaluated and the research data were extracted. The extracted data are analyzed by Revman5.2 software, the heterogeneity is tested, and the corresponding effect model is selected according to the heterogeneity results. Finally, GRADE system is used to evaluate the quality of evidence. Results: after screening 287 articles, a total of 323 children met the inclusion criteria, including 160 in the experimental group and 163 in the control group. Compared with the Intralipid group, the children in the control group recovered birth weight. In the first week, body weight growth rate, mortality, hospitalization time, mechanical ventilation time, oxygen therapy time, incidence of cholestasis, incidence of septicemia, incidence of, BPD (bronchopnea), incidence of, NEC (necrotizing enterocolitis), There was no significant difference in the incidence of severe adverse events, but the incidence of ROP in SMOFlipid group was significantly lower than that in Intralipid group. Compared with Clinoleic group, there was no significant difference in mortality and BPD incidence between MOFlipid group and MOFlipid group. All outcome indexes were classified as medium quality or low quality according to the quality of GRADE system. Conclusion: SMOFlipid infusion in premature infants is safe and effective. The same dose of SMOFlipid is similar to the calorie provided by traditional fat milk, which can meet the energy needs of early growth and development of premature infants. Compared with traditional fat emulsion, SMOFlipid could reduce the incidence of ROP, but there was no significant difference in other clinical outcomes. According to the evidence quality rating of GRADE system, most of the evidence quality is medium quality or low quality.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R722.6
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 王浩;席時(shí)富;;魚油脂肪乳對(duì)胃腸道急診手術(shù)病人機(jī)體免疫和炎性反應(yīng)的影響[J];腸外與腸內(nèi)營養(yǎng);2012年02期
，本文編號(hào)：2478824
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