摘要
目的系统评价早期肠内营养(EEN)和全肠外营养(TPN)对重症急性胰腺炎(SAP)患者预后的影响。方法检索Pubmed(1997～2012.1)、EMbase(1984～2012.1)、Cochrane Central Register of Controlled Trials(Cochrane Library,2012.1)、CBM(1975～2012.1),补充检索纳入研究的参考文献;对符合条件的文献进行资料提取及质量评估后,采用RevMan5.1软件进行分析。结果检索文献385篇,严格按照纳入标准并经过文献质量评估,共纳入14个RCT,合计701例患者(338例接受EEN治疗,363例接受TPN治疗),Meta分析结果显示:与TPN相比,EEN既能降低人工营养相关并发症的发生率,又可降低SAP患者的病死率;同时胰腺相关并发症、多器官功能衰竭及需要手术干预的几率均明显下降,但对于非胰腺相关并发症,两组营养支持的作用无显著性差异[OR=0.52,95%CI(0.26,1.04),P=0.06]。结论在SAP治疗过程中,EEN总体效果优于TPN,在无明显禁忌的情况下首先推荐使用EEN。
Objective To evaluate the superiority between early enteral nutrition （EEN） and total parenteral nutrition （TPN） during the treatment for serious acute pancreatitis （SAP）. Methods The databases such as Pubmed （1997 to January 2012）, EMbase （1984 to January 2012）, Cochrane Central Register of Controlled TriMs of The Cochrane Library （January 2012 ） and CBM （ 1975 to January 2012） were electronically searched, and the relevant references of the included papers were also manually searched. Two reviewers independently screened the trials according to inclusion and exclusion criteria, extracted the data, and assessed the methodology quality. Meta-analyses were performed using the Cochrane Collaboration＇ s RevMan 5.1 software. Results Totally, with the strict standards and quality evaluation, 14 foresight RCT papers were obtained from the total 385 papers, including 701 patients （338 treated by EEN, 363 treated by TPN）. Based on results from analysis, it shows that when compared with EEN, the fatality rate is decreased in the group of EEN , apart from this, the significant decease could also be found in the incidence of pancreas associated complications and the incidence of MOF , besides the incidence of artificial associated complications and rate of intervention by surgery operation. But as to non-pancreas associated complications, there is no difference between two groups. Conclusion EEN is much superior than TPN for SPA during the treatment, and EEN is safe and effective on condition that there is no obvious prohibition.
出处
《肝胆外科杂志》
2013年第1期34-39,共6页
Journal of Hepatobiliary Surgery
关键词
重症胰腺炎治疗
早期肠内营养
全肠外营养
Mata分析
Treatment for serious acute pancreatitis
Early enteral nutrition
Total parenteral nutrition
Meta-analysis
