糖皮质激素治疗儿童脓毒症的疗效:荟萃分析

中国小儿急救医学 Pub Date : 2020-03-20 DOI:10.3760/CMA.J.ISSN.1673-4912.2020.03.011

B. Ling, Z. Mei, F. Xu

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引用次数: 0

摘要

目的探讨糖皮质激素治疗儿童脓毒症的疗效。方法检索PubMed、EMbase、The Cochrane Library、万方数据、VIP、中国知网等数据库，收集自成立以来至2019年7月关于糖皮质激素治疗儿童脓毒症的随机对照试验(RCTs)。两名独立研究人员筛选文献，提取数据，并评估纳入研究的偏倚风险。数据结果采用RevMan5.3软件进行meta分析。结果共纳入7项rct，共1 359例患者。meta分析结果显示，与对照组相比，皮质类固醇治疗组未改善患儿死亡率(OR=1.09, 95%CI 0.61, 1.97, P=0.76)、住院时间(MD=-3.13, 95%CI -8.29, 2.03, P=0.23)、PICU住院时间(MD=-2.33, 95%CI -5.03, 0.37, P=0.09)、机械通气时间(MD=-2.01, 95%CI -4.66, 0.65, P=0.14)、院内感染率(OR=1.58, 95%CI 0.27, 9.21, P=0.61)。结论现有证据表明，糖皮质激素辅助治疗不能有效降低脓毒症患儿的死亡率、住院时间、PICU住院时间、机械通气时间、医院感染率，但受纳入研究数量和质量的限制，需要进一步开展大规模、多中心、双盲、随机对照试验进行验证。关键词:糖皮质激素;脓毒症;孩子;荟萃分析

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The therapeutic effect of glucocorticoids on children with sepsis: A Meta-analysis

Objective To evaluate the effect of glucocorticoid therapy in children with sepsis. Methods Databases including PubMed, EMbase, The Cochrane Library, Wanfang Data, VIP and CNKI were searched from inception to July 2019 to collect randomized controlled trials(RCTs)about glucocorticoid for children with sepsis.Two independent researchers screened the literature, extracted data, and assessed the risk of bias in the included studies.Data results were analyzed by RevMan5.3 software for Meta-analysis. Results A total of 7 RCTs, involving 1 359 patients were included.The results of Meta-analysis showed that, compared with the control group, the corticosteroid treatment group did not improve mortality(OR=1.09, 95%CI 0.61, 1.97, P=0.76), length of stay(MD=-3.13, 95%CI -8.29, 2.03, P=0.23), PICU stay time(MD=-2.33, 95%CI -5.03, 0.37, P=0.09), mechanical ventilation time(MD=-2.01, 95%CI -4.66, 0.65, P=0.14), in hospital infection rate(OR=1.58, 95%CI 0.27, 9.21, P=0.61). Conclusion The existing evidence shows that glucocorticoid adjuvant therapy can not effectively reduce the mortality, hospital stay, PICU stay time, mechanical ventilation time, hospital infection rate of children with sepsis, but it is limited by the number and quality of the included studies, which needs further large-scale, multicenter, double-blind, randomized controlled trials to verify. Key words: Glucocorticoid; Sepsis; Children; Meta-analysis

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来源期刊

中国小儿急救医学

自引率

0.00%

发文量

6226

期刊介绍： Chinese Journal of Neurology was established in 1955, the predecessor of which is Chinese Journal of Neurology and Psychiatry. Chinese Journal of Neurology and Psychiatry has been indexed by MEDLINE until 1996, when it was divided into two journals, Chinese Journal of Neurology, and Chinese Journal of Psychiatry. Chinese Journal of Neurology is now indexed by EM, SCOPUS, AJ, WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 2.755 in 2017, ranking the first among all neurological and psychological journals in China and among all the 142 medical journals published by the Chinese Medical Association. The journal is available both in print and online.