益生菌联合早期肠内营养治疗重症急性胰腺炎临床疗效的Meta分析  

Clinical efficacy of probiotics combined with early enteral nutrition in treatment of severe acute pancreatitis: a meta-analysis

作　　者：薛静 李胜 谢文贤 秦健 缪婷 卢翠洁 王振 王浩 XUE Jing;LI Sheng;XIE Wen-xian;QIN Jian;MIAO Ting;LU Cui-jie;WANG Zhen;WANG Hao(Department of Basic Medicine,Sichuan Vocational College of Health and Rehabilitation,Zigong,Sichuan 643030,China;不详)

机构地区：[1]四川卫生康复职业学院基础医学部,四川自贡643030 [2]自贡市第四人民医院口腔科 [3]乐山市人民医院消化内科 [4]宁夏医科大学基础医学院病原生物学与医学免疫学系

出　　处：《中国微生态学杂志》2021年第12期1413-1419,共7页Chinese Journal of Microecology

摘　　要：目的系统性评价益生菌联合早期肠内营养对重症急性胰腺炎(sever acute pancreatitis, SAP)的临床疗效。方法计算机检索中国知网、万方数据库、维普期刊数据库、PubMed、Embase和The Cochrane Library,收集关于益生菌联合早期肠内营养治疗SAP的临床随机对照试验(randomized controlled trials, RCTs),按照纳入和排除标准筛选文献、提取资料,并对全部纳入的文献进行质量评价,采用Cochrane协作网提供的RevMan 5.3软件进行Meta分析。结果与对照组相比,研究组能够显著降低SAP患者的感染率(OR=0.23,95%CI:0.15~0.35,P<0.001)、病亡率(OR=0.21,95%CI:0.07~0.61,P=0.004)、血淀粉酶(WMD=-49.73,95%CI:-73.91~-25.55,P<0.001)、白细胞数量(WMD=-3.79,95%CI:-4.56~-3.02,P<0.001)、CRP含量(WMD=-33.59,95%CI:-48.31~-18.88,P<0.001),缩短腹痛消失时间(WMD=-12.83,95%CI:-14.73~-10.92,P<0.001)以及住院时间(WMD=-8.66,95%CI:-11.58~-5.75,P<0.001),增加患者血浆中白蛋白(WMD=5.84,95%CI:5.12~6.56,P<0.001)的含量。结论益生菌联合早期肠内营养能够显著降低SAP患者的感染率、病亡率、血淀粉酶、白细胞数量、CRP含量,缩短腹痛消失时间以及住院时间,并且还能增加患者血浆中白蛋白的含量。Objective To systematically evaluate the clinical efficacy of probiotics combined with early enteral nutrition in severe acute pancreatitis(SAP). Methods CNKI, WanFang database, VIP database, PubMed, Embase and The Cochrane Library were searched to collect the clinical randomized controlled trials(RCTs) about probiotics combined with early enteral nutrition in the treatment of SAP. According to the inclusion and exclusion criteria, the literature was screened, the data was extracted, and the quality of all included literature was evaluated. The RevMan 5.3 software provided by the Cochrane Collaboration was used for Meta analysis. Result Compared with the control group, the infection rate in observation group significantly reduced(OR=0.23, 95% CI: 0.15-0.35, P<0.001), so did the mortality rate(OR=0.21, 95% CI: 0.07-0.61, P=0.004), blood amylase(WMD=-49.73, 95% CI:-73.91--25.55, P<0.001), white blood cell count(WMD=-3.79, 95% CI:-4.56--3.02, P<0.001), and CRP(WMD=-33.59, 95% CI:-48.31--18.88, P<0.001);the time to disappearance of abdominal pain(WMD=-12.83, 95% CI:-14.73--10.92, P<0.001) and hospitalization time(WMD=-8.66, 95% CI:-11.58--5.75, P<0.001) shortened, while plasma albumin(WMD=5.84, 95% CI: 5.12-6.56, P<0.001) increased in SAP patients. Conclusion Probiotics combined with early enteral nutrition can significantly reduce the infection rate, mortality rate, blood amylase, white blood cell count, CRP, time to disappearance of abdominal pain and hospitalization time, and increase plasma albumin of SAP patients.

关 键 词：益生菌 早期肠内营养 重症急性胰腺炎 META分析 

分 类 号：R576[医药卫生—消化系统] R459.3[医药卫生—内科学]