摘要
目的评价实施肠内营养时加入二十碳五烯酸(EPA)、γ-亚麻酸(GLA)和抗氧化剂对脓毒症的治疗效果。方法系统检索Cochrane图书馆、PubMed、EMbase、CBM、CNKI和VIP数据库,检索时间截至2012年4月。收集肠内营养添加EPA、GLA和抗氧化剂对脓毒症患者预后影响的临床随机对照试验,采用Cochrane协作网系统评价法评价纳入文献的质量,结果采用Revman 5.0软件进行统计分析。结果最终纳入3项研究,共350例患者进行分析,其中试验饮食组173例,对照饮食组177例。与对照饮食相比,加入EPA、GLA和抗氧化剂的试验饮食能缩短脓毒症患者的住ICU时间(MD=6.21,95%CI:4.61～8.19;P<0.00001)和住院时间(P<0.0001),降低新发器官功能衰竭的几率,无明显不良反应,但不能降低脓毒症患者的28 d死亡率(RR=0.83,95%CI:0.60～1.16,P=0.27),对机械通气时间的影响存有争议。结论肠内营养添加EPA、GLA和抗氧化剂安全性好,有利于脓毒症患者的转归。
Objective To systematically review the efficacy of enteral nutrition with eicosapentaenoic acid （EPA）, gamma-linolenicacid （GLA）, and anti-oxidants for patients with sepsis. Methods We searched the PnbMed, EMbase, Cochrane Library, Wanfang Database, CNKI and VIP for all randomized controlled trims about the efficacy of an enteral diet enriched with EPA, GLA, and anti-oxidants for patients with sepsis. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration＇ s RevMan 5. 0 software. Results Three RCTs involving 350 patients were included in our systematic review. The results showed a significant reduction in the length of ICU stay （MD = 6. 21,95% CI：4. 61-8.19 ; P 〈 O. 00001 ） and hospital stay （P 〈0. 0001 ） ,a fewer development of new organ dysfunctions in the patients fed with the study diet and no more adverse events were observed. However, no significant difference in 28-day mortality of all cause was revealed（RR = O. 83,95% CI： 0. 60-1.16, P = 0. 27 ）. There were controversial results about the duration of mechanical ventilation. Conclusion A diet enriched with EPA, GLA, and elevated antioxidants is safe and beneficial for the clinical outcome in patients with sepsis.
出处
《中国呼吸与危重监护杂志》
CAS
2013年第1期75-79,共5页
Chinese Journal of Respiratory and Critical Care Medicine
