极低出生体质量新生儿输血相关性坏死性小肠结肠炎Meta分析

Transfusion-associated Necrotizing Enterocolitis in Very Low Birth Weight Infants:Meta-Analysis of Observational Data

目的:系统评价输血与极低出生体质量新生儿发生坏死性小肠结肠炎(NEC)的相关性。方法:计算机检索EMBase、PubMed、the Cochrane Library数据库等收集极低出生体质量新生儿输血相关性NEC的病例研究及随机对照试验,检索时限从建库至2021年12月。由2名评价者独立筛选文献、提取资料和评估方法学质量后,采用RevMan 5.3软件进行Meta分析。结果:本研究最终纳入17篇文献,其中3篇为队列研究,14篇为病例对照研究。17篇文献中,3篇研究结果提示输血可增加极低出生体质量新生儿发生NEC的风险,14篇提示输血并未显著增加极低体质量新生儿发生NEC的风险。在合并纳入17篇文献研究结果后,发现输血并未显著增加极低出生体质量新生儿发生NEC的风险(OR=1.44,95%CI 0.87~2.37,P>0.05)。结论:输血并未显著增加极低出生体质量新生儿发生NEC的风险。

Objective:To evaluate the relationship between blood transfusion and the incidence of necrotizing enterocolitis(NEC)in very low birth weight infants.Methods:Several databases,such as Embase,PubMed and the Cochrane Library,were retrieved to obtain relevant case studies and randomized controlled trials of transfusion-related NEC in very low birth weight infants,and other sources for case studies and randomized controlled trials related to blood transfusion-induced NEC in very low birth weight infants from the database establishment to December 2021.The relevant literature,data,and methodological quality were extracted and evaluated by two reviewers independently.Meta-analysis was conducted using RevMan 5.3 software.Results:In total,17 articles were included in this study,3 of which were cohort studies,and 14 of them were case control studies.Among the 17 studies,three suggested that blood transfusion could significantly increase the risk of NEC in very low birth weight infants,while 14 suggested that blood transfusion did not significantly increase the risk of NEC in very low birth weight infants.After combining the results of 17 literatures,it was found that blood transfusion did not significantly increase the risk of NEC in very low birth weight newborns(OR=1.44,95%CI 0.87-2.37,P>0.05).Conclusion:Blood transfusion cannot significantly alter the risk of NEC in very low birth weight neonates.