系统评价我国重症急性胰腺炎患者继发胰腺感染的危险因素

目的:系统评价我国重症急性胰腺炎(severe acute pancreatitis,SAP)继发胰腺感染的危险因素,为临床预防和控制感染提供依据.方法:检索中国知网(CNKI)、维普、万方、中国生物医药、PubMed、Cochrane Library、EMbase等数据库,收集关于我国SAP继发胰腺感染危险因素的病例...

Meta-analysis of risk factors for secondary pancreatic infection of patients with severe acute pancreatitis in China

OBJECTIVE To evaluate the risk factors of secondary pancreatic infection of patients with severe acute pancreatitis(SAP) in China so as to provide rationales for clinical prevention and control of infection. METHODS The databases of PubMed,Embase,Cochrane,CNKI,WanFang,Weipu and CBM were searched by computer for collecting the relevant literatures on risk factors of secondary pancreatic infection of SAP patients in China from the inceptions until October 31,2020.Literature was selected by two independent researchers according to inclusion and exclusion criteria and data were extracted.Meta-analysis was performed by RevMan5.3 software. RESULTS A total of 20 literatures including 2,393 patients were retrieved.There were secondary pancreatic infection(n=827) and non-secondary pancreatic infection(n=1 566).Meta-analysis revealed that SAP types of gallbladder(OR=1.42,95%CI=1.11-1.81),APACHE-Ⅱ score(MD=2.44,95%CI=1.79-3.08),Ranson score(MD=0.74,95%CI=0.54-0.94),fasting time >15 days(OR=3.02,95%CI=1.69-5.40),pancreatic necrosis(OR=3.91,95%CI=1.57-3.91),duration of gastrointestinal dysfunction >5 days(OR=5.49,95%CI=3.91-7.70),diabetic complications(OR=3.31,95%CI=2.10-5.21),mechanical ventilation(OR=1.94,95%CI=1.53-2.45),mechanical ventilation time(MD=9.86,95%CI=9.15-10.56),surgery(OR=4.31,95%CI=2.90-6.41),hypoxemia(OR=3.36,95%CI=2.75-4.10),systemic inflammatory response syndrome(SIRS) (OR=3.84,95%CI=2.55-5.77),multiple organ dysfunction syndrome(MODS) (OR=4.19,95%CI=2.79-6.30),serum albumin(MD=-8.51,95%CI=-9.21 to 7.82),serum creatinine(MD=110.53,95%CI=78.25-142.82) and serum calcium level(MD=-0.29,95%CI=-0.37 to -0.21) were all risk factors for pancreatic infection secondary to SAP(P<0.05).CONCLUSION For a better prognosis,early prophylactic antibiotics should be given according to the risk factors of pancreatic infection secondary to SAP.