Effects of neutrophil elastase inhibitor in patients undergoing esophagectomy: a systematic review and meta-analysis.
Effects of neutrophil elastase inhibitor in patients undergoing esophagectomy: a systematic review and meta-analysis.
复制标题
中性粒细胞弹性蛋白酶抑制剂对食管切除术患者的影响：系统评价和荟萃分析。
DOI：
10.3748/wjg.v21.i12.3720
复制
发表时间：
2015
影响因子：
4.3
通讯作者：
Jie Cai
中科院分区：
文献类型：
--
作者：
Zhiqiang Wang;Long;Yong Yuan;Wen;Zhong;Yu;Jie Cai
目的
评价sivelestat（一种中性粒细胞弹性蛋白酶抑制剂）用于食管切除术患者的获益和安全性。
方法
系统检索了截至2013年11月的在线数据库，包括PubMed、EMBASE、科克伦图书馆、Web of Knowledge和中文数据库（万方数据库、VIP和CNKI）。随机对照试验和高质量的比较研究被认为有资格纳入。由3名评价者对纳入研究的方法学质量进行评价，采用Stata 12.0软件对提取的数据进行分析。风险比（RR）用于表示二分结局的效应量，均数差（MD）或标准化均数差用于表示连续结局的效应量。
结果
13项研究被纳入本系统综述，9项研究被纳入荟萃分析。术后第5天西维来司他组的机械通气时间显著缩短[I（2）= 76.3%，SMD =-1.41，95%CI：-2.63-（-0.19）]。西维来司他显著降低了术后急性肺损伤的发生率（I（2）= 0%，RR = 0.27，95%CI：0.08-0.93）。但并没有降低肺炎、重症监护室住院时间或术后住院时间的发生率，也没有增加吻合口瘘、返神经麻痹、伤口感染、脓毒症和导管相关性发热等并发症的发生率。
结论
中性粒细胞弹性蛋白酶抑制剂对接受食管切除术的患者有益。需要更多高质量、大样本、多中心、随机对照的临床试验来验证。
AIM
To evaluate the benefit and safety of sivelestat (a neutrophil elastase inhibitor) administration in patients undergoing esophagectomy.
METHODS
Online databases including PubMed, EMBASE, the Cochrane Library, Web of Knowledge, and Chinese databases (Wanfang database, VIP and CNKI) were searched systematically up to November 2013. Randomized controlled trials and high-quality comparative studies were considered eligible for inclusion. Three reviewers evaluated the methodological quality of the included studies, and Stata 12.0 software was used to analyze the extracted data. The risk ratio (RR) was used to express the effect size of dichotomous outcomes, and mean difference (MD) or standardized mean difference was used to express the effect size of continuous outcomes.
RESULTS
Thirteen studies were included in this systematic review and nine studies were included in the meta-analysis. The duration of mechanical ventilation was significantly decreased in the sivelestat group on postoperative day 5 [I (2) = 76.3%, SMD = -1.41, 95%CI: -2.63-(-0.19)]. Sivelestat greatly lowered the incidence of acute lung injury in patients after surgery (I (2) = 0%, RR = 0.27, 95%CI: 0.08-0.93). However, it did not decrease the incidence of pneumonia, intensive care unit stay or postoperative hospital stay, and did not increase the incidence of complications such as anastomotic leakage, recurrent nerve palsy, wound infection, sepsis and catheter-related fever.
CONCLUSION
A neutrophil elastase inhibitor is beneficial in patients undergoing esophagectomy. More high quality, large sample, multi-center and randomized controlled trials are needed to validate this effect.
DOI：
10.1164/ajrccm.151.2.7842182
发表时间：
1995-02-01
影响因子：
24.7
作者：
HUDSON, LD;MILBERG, JA;MAUNDER, RJ
通讯作者：
MAUNDER, RJ