重症急性胰腺炎早期肠内营养和肠外营养疗效的荟萃分析

目的为明确早期肠内营养(EN)和全胃肠外营养(TPN)对重症急性胰腺炎(SAP)患者的疗效,对相关文献进行荟萃分析。方法检索1970年1月—2009年6月发表的有关早期EN和TPN治疗SAP的临床随机对照试验的文献。按入选标准,有7项临床试验纳入研究范围,由2名评价者对入选研究中有关试验设计、研究对象的特征、研究结果等内容独立进行摘录,并用RevMan5.0.18软件进行分析。结果早期EN与TPN比较,前者能显著降低胰腺感染发生率(OR=0.38,95%CI:0.18~0.82,P=0.01)及器官衰竭发生率(OR=0.43,95%CI:0.23~0.79,P=0.007),减少手术干预(OR=0.34,95%CI:0.18~0.63,P=0.0006)及病死率(OR=0.41,95%CI:0.19~0.88,P=0.02)。但总的感染率两者差异无统计学意义[OR=0.43,95%CI(0.17,1.10),P=0.08]。结论SAP患者早期EN比TPN更为安全有利。

A meta-analysis of early enteral nutrition versus total parenteral nutrition in patients with severe acute pancreatitis

Objective To study the effect of early enteral nutrition(EN) and total parenteral nutrition(TPN) in patients with severe acute pancreatitis by a mata analysis.Methods Randomized controlled trials of TPN and early EN in patients with severe acute pancreatitis were searched in Medline,Pubmed and Embase from Jan 1970 to June 2009,and Cochrane Library(Issue 2,2009).Seven studies were enrolled into the analysis.The detail about the trial design,characters of the subjects and results of the studies were reviewed ...