肠内营养添加益生菌治疗脓毒症预后和安全性的Meta分析-现代医学

肠内营养添加益生菌治疗脓毒症预后和安全性的Meta分析

单位：1. 广州中医药大学第二临床医学院, 广东广州 510006;
2. 广东省中医院大学城分院重症监护室, 广东广州 510006

分类号：R459.3,R631.1

出版年·卷·期（页码）：2023·51·第八期（1113-1119）

摘要：

目的：系统评价肠内营养添加益生菌治疗脓毒症的预后和安全性。方法：计算机检索国内外文献数据库，搜集肠内营养添加益生菌治疗脓毒症的随机对照试验或回顾性研究，检索时限均从建库至 2023年4月。利用RevMan 5.3 软件进行 Meta 分析。结果：纳入13个临床研究，共计1 441例患者。Meta 分析结果显示，在常规治疗脓毒症的基础上，使用肠内营养添加益生菌的治疗方案不仅可降低住院病死率、28 d死亡率、90 d死亡率，还可降低腹泻、便秘、胃内容物返流和胃潴留的不良反应发生率，但未能降低180 d死亡率以及呕吐和消化道出血的发生率。结论：肠内营养添加益生菌治疗可改善脓毒症患者的短期预后并且安全性高。但受到纳入文献的质量和样本量的限制，仍需大样本、高质量的随机对照研究予以验证。

Objective: To evaluate the prognosis and safety of enteral nutrition combined with probiotics in the treatment of sepsis. Methods: The domestic and foreign literature databases were searched for enteral nutrition combined with probiotics in the treatment of sepsis including the randomized controlled trials or retrospective studies.The search time is from the establishment of the database to April 2023 and RevMan 5.3 software was employed for Meta-analysis. Results: A total of 13 clinical studies were included, involving 1 441 patients.The results of Meta-analysis showed that enteral nutrition combined with probiotics could reduce not only mortality including in-hospital mortality, 28-day mortality and 90-day mortality, but also the incidence of adverse reactions including diarrhea, constipation, gastric contents reflux and gastric retention on the basis of routine treatment of sepsis. However, it could not reduce the 180-day mortality and the incidence of vomiting and gastrointestinal bleeding. Conclusion: Enteral nutrition combined with probiotics can improve the short-term prognosis of patients with sepsis and has high safety, but it still needs to be certified by large samples and high-quality randomized controlled trials due to limitations of the quality and sample size of the including literature.

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