新型脂肪乳剂（SMOFlipid）应用于早产儿肠外营养的系统评价：随机对照试验的meta分析
发布时间：2019-05-17 05:04
【摘要】：目的：系统评价早产儿输注SMOFlipid脂肪乳剂(含大豆油30%、中链甘油三酯30%、橄榄油25%和鱼油15%)的安全性和有效性。 方法：计算机检索PUBMED, EMBASE, Cochrane数据库,中国生物医学文献数据库(CBM),中国知网(CNKI),检索时间均从建库至2014年1月。剔除重复文献后,根据题名及摘要筛查文献,符合要求的文献获取全文进一步筛查,纳入SMOFlipid脂肪乳剂应用于早产儿肠外营养的所有随机对照试验(RCTs)。按照Cochrane协作网系统评价方法,评价纳入研究的质量并提取研究资料。使用Revman5.2软件对提取的数据进行分析,检验异质性,并根据异质性结果选择相应的效应模型。最后采用GRADE系统对证据质量进行评价。 结果：经过对287篇文献进行筛选后,最终纳入6项随机对照试验,总共有323例患儿符合纳入标准,其中实验组160例,对照组163例。SMOFlipid组与Intralipid组相比,患儿恢复出生体重时间、第1周体重增长率、死亡率、住院时间、机械通气时间、氧疗时间、胆汁淤积症发病率、败血症发病率、BPD(支气管肺发育不良)发病率、NEC(坏死性小肠结肠炎)发病率、严重不良事件发生率等均无显著性差异,而在ROP(早产儿视网膜病)的发病率上,SMOFlipid组显著低于Intralipid组。SMOFlipid组与Clinoleic组相比,患儿死亡率、BPD发病率均无显著性差异。所有结局指标根据GRADE系统质量分级均为中等质量或低质量。 结论：早产儿输注SMOFlipid是安全、有效的,相同剂量的SMOFlipid与传统脂肪乳提供的热卡相当,均可满足早产儿生后早期生长发育的能量需求。与传统脂肪乳剂相比,应用SMOFlipid可降低ROP的发病率,但其他临床结局无显著性差异。根据GRADE系统的证据质量评级显示大部分证据质量为中等质量或低质量。
[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.
【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R722.6
本文编号：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.
【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R722.6
【参考文献】
相关期刊论文 前1条
1 王浩;席时富;;鱼油脂肪乳对胃肠道急诊手术病人机体免疫和炎性反应的影响[J];肠外与肠内营养;2012年02期
，本文编号：2478824
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