摘要
目的 评价生长激素治疗烧伤的有效性和安全性。 方法 检索中国生物医学文摘数据库、MEDLINE、EMBASE和Cochrane图书馆 ,收集所有相关随机对照试验 ,对其逐个进行质量评价 ,并进行Meta 分析。 结果 纳入 9个高质量研究 ,共治疗 732例患者。①有助于烧伤创面的愈合 [WMD - 11.2 5 ,95 %CI(- 14 .84 ,- 7.6 6 ) ,P <0 .0 0 0 0 1];②有助于供皮区创面的愈合 [WMD - 1.87,95 %CI(- 2 .2 8,- 1.4 7) ,P <0 .0 0 0 0 1];③有助于缩短住院时间 [WMD - 8.10 ,95 %CI(- 10 .4 0 ,- 5 .79) ,P <0 .0 0 00 1];④使用生长激素后 ,患者静息能量消耗有降低的趋势但尚无统计学意义 [WMD - 0 .0 4 ,95 %CI(- 0 .0 8,0 .0 0 ) ,P =0 .0 6 ];⑤生长激素会引起血糖升高 [SMD 0 .98,95 %CI(0 .5 4 ,1.4 2 ) ,P <0 .0 0 0 0 1],和血胰岛素升高 [SMD 0 .86 ,95 %CI(0 .4 3,1.30 ) ,P =0 .0 0 0 1];病死率 [OR 1.15 ,95 %CI(0 .15 ,8.5 3) ,P =0 .9]和脓毒血症的发生方面无差异 [OR 1.0 8,95 %CI(0 .5 0 ,2 .34) ,P =0 .8]及呼吸机需求方面无差异 (OR 1.5 1,95 %CI(0 .72 ,3.16 ) ,P =0 .3)。 结论 目前资料表明烧伤患者在监测和控制好血糖水平的条件下运用生长激素是安全、有效的。
Objective To assess the effectiveness and the safety of clinical use of growth hormone (GH) in burn patients. Methods Search were applied to the following electronic databases: Ch inese Bio-medicine Database (CBM), MEDLINE, EMBASE and Cochrane Library. Langua ge was restricted in Chinese and English. Data were extracted and evaluated by t he two reviewers independently of each other. Applied RevMan 4.1 for statistical analyse. Results Nine trials involving 732 patients were incl uded. The combined results showed that GH can shorten wound healing time \[weigh ted mean difference (WMD)=-11.25, 95% CI(-14.84, -7.66), P <0.000 01\], donor site healing times \[WMD=-1.87, 95% CI(-2.28, -1.47), P<0.000 01), and length of hospital stay \[WMD=-8.10, 95% CI( -10.40, -5.79), P<0.000 01\]. There was no statistical signi ficance on resting energy expenditure\[WMD=-0.04, 95% CI(-0.08, 0.00) P=0.06\], mortality \[odds ratio (OR) =1.15, 95% CI(0.15,8.53), P=0.9\], sepsis\[OR=1.08, 95% CI (0.50,2.34), P=0.8\ ] and ventilatory support required\[OR=1.51, 95% CI (0.72,3.16), P =0.3\]. Nevertheless, the plasma levels of glucose\[standardized mean differen ce (SMD) =0.98, 95% CI (0.54,1.42), P<0.000 01\] and insulin\[S MD=0.86, 95% CI (0.43,1.30), P=0.000 1\] were increased in GH gr oups. Conclusion GH for burn patients is effective and safe if blood glucose can be controlled well.
出处
《中国循证医学杂志》
CSCD
2004年第2期92-97,共6页
Chinese Journal of Evidence-based Medicine
基金
纽约中华医学会基金资助~~
关键词
生长激素
治疗
烧伤
生物医学
血糖
Growth hormone
Burn
Randomized cont rolled trials
Systematic review
Meta-analysis
