不同胰岛素输注方式在肠外营养中应用效果的Meta分析  

Different Insulin Regimens in Patients with Parenteral Nutrition Support:A Network Meta-analysis

作　　者：白春花[1] 陈莉[1] 傅巧美[1] BAI Chunhua;CHEN Li;FU Qiaomei(Department of General Surgery,Nanjing Drum Tower Hospital,Nanjing210008,Jiangsu Province,China)

机构地区：[1]南京鼓楼医院普通外科,江苏南京210008

出　　处：《解放军护理杂志》2018年第23期27-32,36,共7页Nursing Journal of Chinese People's Liberation Army

基　　金：国家临床重点专科建设项目[卫办医政函[(2011)872号];南京鼓楼医院重点护理科研项目(ZSB210)

摘　　要：目的评价不同胰岛素输注方式在肠外营养中的应用效果。方法计算机检索国内外关于肠外营养中胰岛素输注方式的随机对照研究,经文献质量评价后,使用RevMan 4.3.2和Stata 14.0进行Meta分析。结果胰岛素泵静脉输注胰岛素可以显著缩短切口愈合时间,减少住院天数;采用胰岛素泵持续皮下输注胰岛素能够显著降低术后切口感染发生率,促进切口愈合。网状Meta分析结果显示:就血糖控制及血糖异常发生情况综合而言,将胰岛素直接加入营养液中是肠外营养过程中最佳胰岛素输注方式。结论多种胰岛素输注方式可用于肠外营养治疗过程中,应根据实际情况采用合适的胰岛素输注方案,并进一步开展多中心、大样本、高质量随机对照研究以确定肠外营养支持治疗过程中的最佳胰岛素输注方式。Objective To evaluate the effect of different insulin regimens in patients with parenteral nutrition support.Methods The electronic databases were searched for the randomized controlled studies of insulin regimens in patients with parenteral nutrition support.The data were analyzed by using Review Manager4.3.2and Stata14.0.Results Intravenous insulin infusion with pump could shorten the wound healing time and the length of hospital stay.Continuous subcutaneous insulin infusion could reduce the wound infection rate and promote wound healing.The network Meta-analysis showed that adding insulin into“all in one”bags directly was the best regimen in terms of glycemic control and incidence of abnormal blood glucose during parenteral nutrition.Conclusions A variety of insulin regimens can be used in parenteral nutrition treatment,and appropriate insulin regimens should be adopted based on the actual situation.However,further multi-center,large-sample,and high-quality randomized controlled studies are required to establish the best insulin regimen to treat patients on parenteral nutrition.

关 键 词：肠外营养 胰岛素 血糖控制 并发症 

分 类 号：R473.58[医药卫生—护理学]