| 0bjective To evaluate The impact of Intensive Insulin Therapy（IIT） onthe clinical Outcome of patients with Severe BurnMethods We conducted searches of electronic databases abstracts fromMEDLINE （1966-2011）,EMBASE （1977-2011）,Cochrane Library(1948-2011), Wan fang Data (1994to2011) CNKI (1994-2011).We includedpublished randomized controlled trials（RCTs）that directly compared IIT withconventional glucose management. Clinical outcome index includedmortality，sepsis, organ dysfunction rate, inflammation response after Severeburn, Hypoglycemic events. Methodological quality of the study was assessedbased on Cochrane Reviewers`Handbook and Jadad`s Score Scale, and themeta-analysis was conducted with RevMan5.0software.Results: Among563related articles，6studies included a total of376patients were included, all of which are RCT. Meta-analysis showed that therewas statistical difference in comparision of IIT group with control groupabout the mortality,［RR=0.36，95％CI为0.16-0.84，P=0.02］. compared with control group, IIT reduced the incidence of complications such as sepsis,organ dysfunction rate, statistical difference was found between IIT groupand control group,[RR=0.26，95％CI0.12-0.57，P=0.0009],[RR=0.35，95％CI为0.15-0.82，P=0.02]．there was heterogeneity among the2RCTs,random—effect model was applied, No statistical difference was foundbetween IIT group and control group in respect of inflammation response afterSevere burn (P>0．05)．[RR=-57.17，95％CI-132.59-18.24，P=0.14]. butIIT increased the incidence of Hypoglycemic events, statistical differencewas found between IIT group and control group,[RR=2.75，95％CI2.11-3.60，P=0.00001].Conclusion: With good monitoring of blood glucose， Intensive insulintherapy to maintain blood glucose between80-150mg per deciliter may reducethe morbidity and mortality among patients with Severe Burn, improve theclinical Outcome of patients with Burn, Studies with a large sample are neededto verify the efficiency. |
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