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目的:系统评价早期脂肪乳治疗早产极低出生体重儿的疗效与安全性。方法:计算机检索Pub Med、Cochrane Central Register of Controlled Trials、MEDLINE、EMBASE、OVID、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方数字化期刊全文数据库,检索时间从建库至2015年3月。纳入早期脂肪乳治疗早产极低出生体重儿的所有随机对照试验(randomized controlled trial,RCTs),并逐个进行质量评价和资料提取。统计学分析采用Rev Man5.2软件进行Meta分析。结果:共纳入13个RCTs,包括852例患者(实验组:440例患者,对照组:412例患者)。Meta分析结果表明,试验组恢复出生体重时间较对照组缩短(MD=-3.09,95%CI=-3.58~-2.60,P<0.000 01);2组新生儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)发生率、败血症发生率、黄疸发生率、住院期间死亡率、高甘油三酯血症发生率、低血糖发生率及支气管肺发育不良(bronchopulmonary dysplasia,BPD)发生率无差异[NEC发生率(RR=0.66,95%CI=0.33~1.32,P=0.24);败血症发生率(RR=0.85,95%CI=0.72~1.00,P=0.05);黄疸发生率(RR=1.03,95%CI=0.84~1.25,P=0.78);住院期间死亡率(RR=0.93,95%CI=0.70~1.22,P=0.59);高甘油三酯血症发生率(RR=1.24,95%CI=0.75~2.04,P=0.41);低血糖发生率(RR=1.55,95%CI=0.82~2.92,P=0.17);BPD发生率(RR=0.92,95%CI=0.70~1.20,P=0.53)。结论:早期脂肪乳(≤2 d)治疗早产极低出生体重儿是安全有效的,不仅缩短了恢复出生体质量时间,而且并未增加其他不良反应的发生。
OBJECTIVE: To systematically evaluate the efficacy and safety of early fat emulsion in treating very low birth weight premature children. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, OVID, CBM, CNKI, VIP, Wanfang Digitized Periodicals Database, search time from building to March 2015. All randomized controlled trials (RCTs) were included in the treatment of preterm low birth weight infants with early fat emulsion, and the quality evaluation and data extraction were carried out one by one. Statistical Analysis Meta-analysis was performed using Rev Man 5.2 software. Results: A total of 13 RCTs were enrolled, including 852 patients (experimental group: 440 patients, control group: 412 patients). The result of Meta analysis showed that the body weight of the experimental group was shorter than that of the control group (MD = -3.09, 95% CI = -3.58 ~ -2.60, P <0.000 01). Necrotizing enterocolitis NEC), incidence of sepsis, incidence of jaundice, in-hospital mortality, incidence of hypertriglyceridemia, incidence of hypoglycemia and incidence of bronchopulmonary dysplasia (BPD) [NEC incidence (RR = 0.66, 95% CI = 0.33-1.32, P = 0.24); incidence of sepsis (RR = 0.85,95% CI = 0.72-1.00, P = 0.05); incidence of jaundice (RR = 0.93, 95% CI = 0.70 to 1.22, P = 0.59); the incidence of hypertriglyceridemia (RR = 1.24, 95% CI = 0.75 ~ 2.04, P = 0.41); incidence of hypoglycemia (RR = 1.55, 95% CI = 0.82-2.92, P = 0.17); incidence of BPD (RR = 0.92, 95% CI = 0.70-1.20, P = 0.53) . Conclusions: Early fat emulsion (≤2d) is safe and effective in treating preterm low birth weight infants, which not only shortens the time of restoring birth weight but also does not increase the incidence of other adverse reactions.