摘要
目的探讨并对比不同时间开始的肠外营养与肠内营养对急性胰腺炎的影响。方法在MEDLINE、EMBASE、Cochrane图书馆、万方期刊库和中国期刊网检索1966年1月至2011年1月发表的有关全胃肠外营养和肠内营养治疗急性胰腺炎的随机对照研究。由2名评价者对入选研究的研究设计、研究对象的特征、研究结果等内容独立进行摘录，采用RevMan4．2软件进行分析。结果有14项研究纳入本研究。本研究结果显示，入院24h后，与全胃肠外营养相比，肠内营养能显著降低感染（P=0．0004）、手术（P=0．0200）、器官衰竭（P=0．0400）及死亡率（P=0．0002）；入院48h内，与全胃肠外营养相比，肠内营养能显著降低感染（P=0．0000）、手术（P=0．0001）、器官衰竭（P=0．0006）及死亡率（P=0．0300）。结论肠内营养的疗效可能受营养开始时间的限制，急性胰腺炎患者入院24—48h开始肠内营养优于入院24h内或48h后开始。
Objective To compare the effect of parenteral nutrition and enteral nutrition with different start time on acute pancreatitic patients. Methods Randomized controlled trials comparing enteral and parenteral nutrition in acute pancreatitic patients published from January 1996 to January 2011 were searched in MEDLINE, EM- BASE, Cochrane databases, Wanfang science library, and China National Knowledge Infrastructure. The informa- tion about study design, patient characteristics, and outcomes were extracted by two independent analysers before processed with RevMan 4. 2 software. Results Altogether 14 trials were included. When started after 24 hours of admission, enteral nutrition, in comparison with total parenteral nutrition, resulted in a statistically significant re- duction in the risks of infeetions（ P = O. 0004 ）, surgical intervention （ P = 0. 0200 ）, organ failure （ P = 0. 0400）, and mortality （P = 0. 0002） in acute pancreatitie patients. When started within 48 hours of admission, enteral nutrition, in comparison with total parenteral nutrition, resulted in a statistically significant reduction in the risks of infections （P =0. 0000）, surgical intervention （P =0. 0001 ）, organ failure （P =0. 0006）, and mortality （P = 0. 0300） in acute pancreatitic patients. Conclusions The time of the commencement of nutrition has an in- fluence on the benefits of enteral nutrition. Enteral nutrition started between 24 hours and 48 hours of admission is more effective than within 24 hours or after 48 hours of admission.
出处
《中华临床营养杂志》
CAS
2012年第6期363-368,I0005,共7页
Chinese Journal of Clinical Nutrition
关键词
急性胰腺炎
肠内营养
全胃肠外营养
营养时间
荟萃分析
Acute pancreatitis
Enteral nutrition
Total parenteral nutrition
Nutrition time
Meta-analysis
