The impact of fish oil (ω-3 fatty acids) intervention on infectious complications and cost-effectiveness for postoperative patients: systematic review (2010-2016)

目的 评价鱼油(ω-3脂肪酸)干预对外科手术后非重症患者结局的影响.方法 计算机检索数据库PubMed、Embase、Cochrane、CNKI、万方等,检索符合纳入排除标准的择期手术后应用肠外营养患者进行静脉鱼油(Omegawen)干预有临床结局指标的随机对照研究(RCT).文献发表时间从2010年1月至2016年6月.采用Jadad量表、Schulz隐蔽分组评价进行文献质量评价.采用RevMan 5.3软件进行Meta分析.结果 最终纳入19项RCT研究,含1 170例外科手术后患者.Meta分析结果显示:鱼油短期干预可降低感染并发症发生率[RR=0.44,95％ CI (0.31,0.64),P＜0.000 1],减少手术后住院时间[MD=-0.85,95％ CI(-1.67,-0.03),P=0.04],不影响病死率[RR =0.42,95％ CI (0.07,2.63),P=0.36]与住院总费用[MD=-216.60,95％ CI(-718.94,285.75),P=0.40].敏感性分析结果与前一致.结论 现有证据表明外科手术后应用鱼油,可显著降低感染并发症和减少手术后住院时间.Objective To evaluate the impact of fish oil (ω-3 fatty acids) parenteral nutrition (PN) on outcomes for non-ICU postoperative patients.Methods PubMed,Embase,Cochrane,China National Knowledge Infrastructure (CNKI) and Wanfang Database etc.were searched to retrieve the eligible studies published from January 2010 to June 2016.The studies included were randomized controlled trials (RCTs) that evaluated the effects of supplementation of fish oil (Omegawen) in PN regimens for postoperative patients on clinical outcomes.The methodological quality assessment was based on Jadad scale and Schulz allocation concealment tool.Meta-analysis was conducted by RevMan 5.3 software.Results 19 RCTs,1 170 surgical patients,were included.Meta-analysis indicated that short-term fish oil supplementation significantly reduced the incidence of infectious complications [RR =0.44,95％ CI (0.31,0.64),P ＜0.000 1] and shortened the length of hospital stay [MD =-0.85,95％ CI (-1.67,-0.03),P=0.04],while with no significant effect on mortality [RR =0.42,95％ CI (0.07,2.63),P =0.36] and total expenditure of hospitalization [MD =-216.60,95％ CI (-718.94,285.75),P =0.40].Sensitivity analysis showed similar results.Conclusion According to existing evidence,fish oil in PN for surgical patients could reduce the incidence of postoperative infectious com-plications and shorten the length of hospital stay.吴阶平医学研究基金(2009-1)Wu Jieping Medical Research Foundation中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)6323-3312