人血白蛋白与晶体液对成人脓毒症及脓毒症休克患者液体复苏作用Meta分析

Albumin vs. Crystalloids in Fluid Resuscitation for Adults with Severe Spesis and Septic Shock: a Meta-analysis

目的系统评价使用人血白蛋白与晶体液对成人脓毒症及脓毒症休克患者液体复苏作用的影响。方法采用计算机检索Cochrane Library、Pubmed、Embase、中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库,检索时间从建库至2015年11月,对符合纳入标准的随机对照试验(RCT)进行质量评价,并采用Rev Man5.3版软件进行Meta分析。结果共纳入4项RCT,合计患者3 862例。人血白蛋白和晶体液对患者28 d死亡率[RR=0.95,95%CI(0.86,1.05),P=0.33]、90 d死亡率[RR=0.95,95%CI(0.86,1.05),P=0.33]、重症监护室住院时间、总住院时间、机械通气时间、肾脏替代治疗等结局指标的影响均差异无统计学意义。结论人血白蛋白和晶体液作为复苏液体,对成人脓毒症或脓毒症休克患者的预后差异无统计学意义。

Objective To systematically evaluate the effects of albumin compared with crystalloids on fluid resuscitation for adults with severe sepsis and septic shock. Methods The six databases as follows：Cochrane Library,Pubmed,Embase,CNKI,VIP and Wanfang,were retrieved by computer,from their inception to November,2015.Randomized controlled trials（RCT） in the treatment of adult patients with severe sepsis and septic shock were included for quality assessment and Meta-analysis was performed by using RevMan5.3 software. Results A total of 4 RCTs involving 3 862 participants were included.No differences were found between albumin and crystalloids resuscitation with respect to 28-day mortality[RR=0.95,95%CI（0.86,1.05）,P=0.33],90-day mortality[RR=0.95,95%CI（0.86,1.05）,P=0.33],duration of stay in ICU,duration of hospital stay,duration of mechanical ventilation and renal replacement therapy. Conclusion In that meta-analysis,the effects of fluid resuscitation with albumin or crystalloids were not significantly different in adults with severe sepsis and septic shock.