目的 通过Meta分析评价谷氨酰胺治疗成年严重烧伤患者的临床效果。方法 计算机检索PubMed、Embase、Cochrane图书馆、中国知网、万方、百度学术(建库至2023年6月28日)中比较应用谷氨酰胺与安慰剂治疗严重烧伤成年患者的临床随机对照研究,经过严格的质量评价后使用Revman5.3软件进行Meta分析。评价指标为死亡率、感染率、住院时间及重症监护室(ICU)治疗时间。结果 共纳入11项临床随机对照研究,包含1620例患者。Meta分析结果显示:与对照组相比,使用谷氨酰胺治疗组在死亡率(RR=0.95, 95% CI, 0.74～1.23; P=0.72)、院内感染率(RR=0.94, 95% CI, 0.77～1.14; P=0.51)、重症监护室(ICU)治疗时间(MD=-1.85 d; 95% CI,-6.31～2.60 d; P=0.41)方面差异均无统计学意义;平均住院时间谷氨酰胺治疗组少于对照组(MD=-4.77 d; 95% CI,-9.43～-0.12 d; P=0.04),差异有统计学意义。结论 使用谷氨酰胺治疗成年严重烧伤患者能够缩短平均住院时间,但在降低死亡率和感染率,以及减少重症监护室治疗时间方面未见明显优势,建议临床谨慎使用。
Abstract
Objective To evaluate the clinical efficacy of glutamine on adult patients with severe burn by meta-analysis. Methods Randomized controlled clinical trials of glutamine for severe burn of adult patients were retrieved from PubMed, Embase, Cochrane Library, China HowNet, Wanfang HowNet, and Baidu Academic databases. Meta-analysis was performed using RevMan 5.3 software after strict quality evaluation. Clinical indicators were mortality, infection rate, length of hospital stay and intensive care unit (ICU) treatment time. Results A total of 11 randomized controlled trials (RCTs) were included, involving a total of 1620 patients. Compared with the control group, there were no statistically significant differences in mortality (RR=0.95, 95% CI, 0.74- 1.23; P=0.72), hospital infection rate (RR=0.94, 95% CI, 0.77-1.14; P=0.51), or intensive care unit (ICU) treatment time (MD=-1.85 d; 95% CI, -6.31-2.60 d; P=0.41) between the glutamine treatment group and the control group, but mean length of hospital stay in the glutamine treatment group was less than that in the control group (MD=4.77 d; 95% CI, -9.43- -0.12 d; P=0.04), the difference was statistically significant. Conclusions The use of glutamine in the treatment of adult patients with severe burn can shorten the average hospitalization stay, but there is no significant advantage in reducing mortality, infection rate, or intensive care unit (ICU) treatment time, so it is recommended to use it with caution in clinical practice.
关键词
烧伤 /
谷氨酰胺 /
Meta分析 /
临床随机对照研究
Key words
burns /
glutamine /
Meta-analysis /
clinical randomized controlled study
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