经皮穿刺置管引流术治疗重症急性胰腺炎的Meta分析  

The efficacy of percutaneous catheter drainage(PCD)for severe acute pancreatitis(SAP)

作　　者：陈浩[1] 方茂勇[1] CHEN Hao;FANG Mao-yong(Department of emergency surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院急诊外科,合肥230022

出　　处：《肝胆外科杂志》2019年第6期429-433,共5页Journal of Hepatobiliary Surgery

摘　　要：目的系统评价经皮穿刺置管引流术(percutaneous catheter drainage,PCD)治疗重症急性胰腺炎(severe acute pancreatitis,SAP)的临床疗效。方法通过检索CBM、Embase、SCI、Cochrane Library,PubMed,维普数据库,中国知网数据库,万方数据库的所有文献,搜索岀PCD治疗SAP患者的随机对照试验(randomized controlled trial,RCT),对纳入的研究进行方法学质量评价并提取相关数据,用Revman 5.3软件对数据进行Meta分析并对结果进行系统评价。结果本研究共纳入13个RCT临床研究,共计981例研究对象。结果显示:PCD+常规治疗在以下方面优于单纯常规治疗,且具有统计学意义:(1)血淀粉酶恢复时间:MD=-2.68,95%CI:(-3.47,-1.88),(2)临床症状消失时间:MD=-6.55,95%CI:(-10.71,-2.39);(3)肠功能恢复时间:MD=-2.68,95%CI:(-3.76,-1.60);(4)并发症发生率:RR=0.28,95%CI:(0.20,0.40);(5)多器官功能衰竭综合征(multiple organ dysfunction syndrome,MODS)发生率:RR=0.39,95%CI:(0.25,0.59);(6)中转手术率:RR=0.23,95%CI:(0.09,0.59);(7)有效率:RR=1.40,95%CI:(1.23,1.59);(8)住院时间:MD=-11.51,95%CI:(-13.90,-9.12)。结论目前研究表明PCD+常规治疗SAP的疗效明显优于单纯常规治疗,但均为国内文献.且纳入样本质量相对不高,为充分证实其疗效,今后有必要开展更多高质量RCT研究。Objective To assess the efficacy of percutaneous catheter drainage(PCD)for severe acute pancreatitis(SAP).Methods Cochrane Library,CBM,PubMed,Embase,SCI,VIP,CNKI and WANFANG database were searched to screen out randomized controlled trials of PCD combined with conventional treatment compare with conventional treatment for SAP.Do methodological quality assessment and extract the relevant data from the included studies.The data were analyzed by using Revman 5.3 software.Results Thirteen studies(981 patients)were included.The results of meta analysis show significant differences between the two groups(PCD combined with conventional treatment and conventional treatment):(1)lime to remission of serum amylase:MD=-2.68,95%CI:(-3.47,-1.88);(2)symptom disappearance time:MD=-6.55,95%CI:(-10.71,-2.39);(3)recovery time of intestinal function:MD=-2.68,95%CI:(-3.76,-1.60);(4)incidence of complication:RR=0.28,95%CI:(0.20,0.40);(5)incidence of multiple organ dysfunction syndrome:RR=0.39,95%CI:(0.25,0.59);(6)operation rate:RR=0.23,95%CI:(0.09,0.59);(7)efficient rate:RR=1.40,95%CI:(1.23,1.59);(8)hospitalization stay:MD=-11.51,95%CI:(-13.90,-9.12).Conclusion These researches indicate that PCD combined with conventional treatment is superior to conventional treatment for SAP.Yet,we need to conduct further high-quality randomized controlled studies.

关 键 词：经皮穿刺置管引流术 重症急性胰腺炎 META分析 

分 类 号：R659[医药卫生—外科学]