Clinical evidence of growth hormone for patients undergoing abdominal surgery: Meta-analysis of rand

• 作 者: Yong Zhou Xiao-Ting Wu Gang Ya
• 机 构: Department of General Surgery,Chinese Evidence-Based Medicine/Cochrane Center
• 出 处: 世界胃肠病学杂志（英文版）
• 发表日期: 2004年期
• 关键词: Perioperative growth hormone Abdominal surgery

AIM: To assess the effectiveness and safety of perioperative growth hormone (GH) in patients undergoing abdominal surgery.METHODS: We searched the following electronic databases: MEDLINE, EMBASE, the Cochrane Controlled Trials Register, Chinese Bio-medicine Database. The search was undertaken in February 2003. No language restrictions were applied. Randomized controlled trials (RCT) comparing GH with placebo in patients undergoing abdominal surgery were extracted and evaluated.Methodological quality was evaluated using the Jadad scale.RESULTS: Eighteen trials involving 646 patients were included. The combined results showed that GH had a positive effect on improving postoperative nitrogen balance (standardized mean difference [SMD] = 3.37, 95%CI [2.46, 4.27], P＜0.00001), and decreasing the length of hospital stay (weighted mean difference [WMD] = -2.07,95%CI [-3.03, -1.11], P = 0.00002), and reducing the duration of postoperative fatigue syndrome (SMD = -1.83,95%CI [-2.37, -1.30], P＜0.00001), but it could increase blood glucose levels (WMD = 0.91, 95%CI [0.56, 1.25],P＜0.00001).CONCLUSION: GH for patients undergoing abdominal surgery is effective and safe, if blood glucose can be controlled well. Further trials are required with a sufficient size to account for clinical heterogeneity and to measure other important outcomes such as infection, morbidity,mortality, fluid retention, immunomodulatory effects, and tumor recurrence.