糖皮质激素预防内镜逆行胰胆管造影术后胰腺炎的系统评价  

A Systematic Review of Corticosteroid in Preventing for Post-ERCP Pancreatitis by Randomized Controlled Trials

作　　者：潘涛[1] 王一平[1] 吴宗英[1] 曾超[1] 

机构地区：[1]四川大学华西医院消化内科,四川成都610041

出　　处：《华西医学》2006年第4期665-667,共3页West China Medical Journal

摘　　要：目的:评价糖皮质激素能否降低内镜逆行胰胆管造影术(ERCP)术后胰腺炎(PEP)的发生率及严重程度,以及临床应用的安全性。方法:通过计算机检索和手工检索全面收集全世界关于糖皮质激素预防PEP的临床随机对照试验(RCT),并按Cochrane协作网推荐的方法进行系统评价。结果:共6篇RCT包括2518例患者被纳入评价。Meta分析结果显示糖皮质激素不能降低PEP[OR1·19,95%CI0·93to1·53;P=0·16]和重度PEP[OR1·61,95%CI0·74to3·53;P=0·2]的发生率。结论:目前的证据不支持糖皮质激素可降低PEP的发生率,还有增加PEP的发生率和严重程度的趋势,故不推荐糖皮质激素用于临床PEP的预防,是否有必要进行进一步的临床试验需审慎看待。Objective： To evaluate the effectiveness and safety of corticosteroid in preventing post - ERCP pancreatitis. Methods： Randomized controlled trials on corticosteroid preventing post- endoscopic retrograde cholangiopanereatography pancreatitis （PEP） were identified by electronic and handsearching related data. Systematic review was conducted using the methods recommended by the Cochrane Collaboration. Results： Six trials involving 2518 patients undergoing ERCP were included. Meta analysis showed that the incidence of PEP [OR 1.19, 95% CI 0.93 to 1.53; P = 0.16] and severe PEP [OR 1.61, 95% CI 0.74 to 3.53; P = 0.2] couldn＇t be reduced by cortieostemid. Conclusion： Existing evidence did not support corticostervid could reduce the incidence of PEP, Meta analysis even showed that it had the tendency to increase the incidence of PEP and its severity, and should not be recommended in its application on patients, and whether it was necessary to carry out further clinical trials should be considered with care.

关 键 词：内镜逆行胰胆管造影术后胰腺炎 糖皮质激素 随机对照试验 META分析 系统评价 

分 类 号：R576[医药卫生—消化系统]