肠内营养与肠外营养对危重症临床疗效的Meta分析

发布时间：2018-05-07 18:30

本文选题：肠内营养 + 肠外营养　；参考：《肠外与肠内营养》2017年05期

【摘要】：目的:通过Meta分析方法系统评价肠内营养(EN)与肠外营养(PN)对危重症的临床疗效。方法:检索Pub Med、Embase、Springerlink、Medline、中国知网、万方、维普数据库(建库至2016年4月22日),纳入有关肠内营养与肠外营养治疗的随机对照试验(RCT),以总并发症发生率、总感染率、肺炎发生率、尿路感染率、脓毒症及其他感染发病率、死亡率、住院时间等为效应指标,由两名研究者独立对入选文献的质量和研究结果进行摘录,应用Review Manager 5.3进行Meta分析。结果 :Meta分析结果显示,与肠外营养相比,肠内营养显著降低了总感染发生率(OR=0.54,P=0.04)、肺炎发生率(OR=0.65,P=0.04)及脓毒症及其他感染发生率(OR=0.59,P=0.04),两者在总并发症发生率、尿路感染率、死亡率及住院时间均无显著差异。结论 :肠内营养能显著降低危重症病人感染的发生,特别是降低肺炎、脓毒症及相关性炎症反应的发生。
[Abstract]:Objective: to evaluate the clinical efficacy of enteral nutrition (en) and parenteral nutrition (PN) in critically ill patients by Meta analysis. Methods: to search the Pub Medbase, China Zhiwang, Wanfang, Weipu database (established until April 22, 2016), and to include RCTA in randomized controlled trials about enteral nutrition and parenteral nutrition treatment, in order to determine the total incidence of complications, total infection rate, and incidence of pneumonia. Urinary tract infection rate, incidence of sepsis and other infections, mortality rate and length of stay were used as effective indexes. The quality and research results of the selected literature were extracted by two researchers independently, and Meta analysis was carried out with Review Manager 5.3. Results compared with parenteral nutrition, enteral nutrition significantly decreased the incidence of total infection and pneumonia, and the incidence of sepsis and other infections was 0.59% and 0.04%, respectively. The incidence of total complications and urinary tract infection was significantly lower than that of parenteral nutrition, and the incidence of pneumonia was 0.65% (P < 0.05), and the incidence of sepsis and other infections was 0.59% (P < 0.05), and the rate of urinary tract infection was significantly lower than that of parenteral nutrition (P < 0.05). There was no significant difference in mortality and hospital stay. Conclusion: enteral nutrition can significantly reduce the incidence of infection in critically ill patients, especially pneumonia, sepsis and associated inflammation.
【作者单位】：湘潭市中心医院重症医学科;南华大学附属南华医院急诊科;
【基金】：南华大学学位与研究生教育教研教改课题资助(2014JG013)
【分类号】：R459.3

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