ω-3脂肪酸对肝切除患者并发症影响的荟萃分析  

Effect of ω-3 fatty acids on complications in patients undergoing hepatectomy: A meta-analysis

作　　者：那延立 张城硕[2] 陈保民[2] 李峰 焦奥[2] 孙宁[2] 张佳林[2] Na Yanli;Zhang Chengshuo;Chen Baomin;Li Feng;Jiao Ao;Sun Ning;Zhang Jialin(The First Department of General Surgery,Northeast International Hospital,Shenyang 110623,China;Hepatobiliary Surgery Department and Unit of Organ Transplantation,First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中一东北国际医院普通外一科,沈阳110623 [2]中国医科大学附属第一医院肝胆外科暨器官移植科,沈阳110001

出　　处：《中华临床医师杂志（电子版）》2017年第22期2407-2413,共7页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的系统评价ω-3脂肪酸对肝切除患者术后临床疗效的影响。方法计算机检索Pub Med,Embase,Cochrane Library数据库,并辅以手工检索、文献追溯,收集2016年9月前发表的关于ω-3脂肪酸对肝切除患者术后临床疗效影响的随机对照试验文献(RCT)。本研究按照系统综述和荟萃分析优先报告的条目(PRISMA)要求进行RCT文献数据提取及质量评价。采用GRADE Profiler系统评价方法来评价所获取证据的质量。采用Q检验和I2检验评价统计学异质性,分析术后总并发症发生率、术后感染并发症发生率、住院时间以及术后病死率,采用Z检验分析荟萃分析的合并效应量。结果根据纳入标准,本研究共筛选6篇文献。ω-3脂肪酸组肝切除患者术后总并发症发生率低于对照组[25.5%(66/259)vs 42.7%(111/260)],差异具有统计学意义(RR=0.60,95%CI0.46~0.76,Z=4.11,P<0.001);术后感染并发症发生率低于对照组[10.3%(30/290)vs 21.2%(62/292)],差异具有统计学意义(RR=0.49,95%CI 0.33~0.73,Z=3.54,P<0.001);患者住院时间短于对照组[(8.4~12.7)d vs(8.6~15.9)d],差异具有统计学意义(SMD=-0.49,95%CI-0.81^-0.16,Z=2.89,P=0.004),但2组患者术后病死率差异无统计学意义(RR=0.46,95%CI 0.16~1.31,Z=1.45,P=0.15)。结论肝切除患者应用ω-3脂肪酸可降低术后总并发症发生率、感染并发症发生率并缩短住院时间,但对术后病死率无明显改善。Objective To compare postoperative outcomes between patients undergoing hepatectomy who received perioperative ω-3 fatty acids and those who did not. Methods Pub Med, Embase, and Cochrane Central Register of Controlled Trials database were searched to retrieve all of the randomized controlled trials（RCTs） evaluating the value of perioperative ω-3 fatty acids in patients undergoing hepatectomy until the end of September 2016. Data extraction and quality assessment of RCTs were performed in accordance with PRISMA guidelines. The quality of evidence for each postoperative outcome was assessed using the GRADEpro analysis. A random-effects model was used to conduct this meta-analysis with Rev Man 5.3.5 software. Results Six RCTs were identified. ω-3 fatty acids significantly reduced the incidence of overall postoperative complications（Risk ratio [RR]=0.60, 95% confidence interval [CI]： 0.46-0.76, Z=4.11, P〈0.001） and infectious complications（RR=0.49, 95%CI： 0.33~0.73, Z=3.54, P〈0.001）, and shortened the length of hospital stay（standardized mean difference=-0.49, 95%CI：-0.81--0.16, Z=2.89, P=0.004）. There was no significant between-group difference in postoperative mortality（RR=0.46, 95%CI： 0.16-1.31, Z=1.45, P=0.15）. Conclusion ω-3 fatty acids are potentially beneficial in reducing overall and infectious postoperative complications and in shortening the hospital stay for patients undergoing hepatectomy.

关 键 词：肝切除 Ω-3脂肪酸 随时对照试验 荟萃分析 

分 类 号：R735.7[医药卫生—肿瘤]