摘要
目的分析全胃肠外营养(total parenteral nutrition,TPN)和全肠内营养(total enteral nutrition,TEN)对重症急性胰腺炎(severe acute pancreatitis,SAP)患者的作用。方法检索1966-2010年发表的有关TPN和TEN治疗AP的随机对照临床试验。按入选标准,有6项临床试验纳入本研究,由两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STATA 11.0软件进行分析。结果与TPN比较,TEN能显著降低胰腺感染并发症(RR=0.556,95%CI为0.436～0.709,P=0.000)、多脏器功能衰竭(multiple organfailure,MOF)(RR=0.395,95%CI为0.272～0.573,P=0.003)、外科干预(RR=0.556,95%CI为0.436～0.709,P=0.000)及病死率(RR=0.426,95%CI为0.238～0.764,P=0.167)。胰腺外感染并发症差异无统计学意义(RR=0.853,95%CI为0.490～1.483,P=0.017),但在非感染性并发症方面,TPN优于TEN(RR=2.697,95%CI为1.947～3.735,P=0.994),住院时间两者无明显差异。结论 AP患者应首先考虑选用TEN作为常规治疗,其效果优于TPN。
Objective To analyze the efficacy of total parenteral nutrition （TPN） and total enteral nutrition（TEN） in patients with severe acute pancreatitis. Methods Randomized controlled trials of TPN and TEN in patients with acute pancreatitis were searched in NCBI from 1966 to 2010. Six studies were included in the analysis and the details about the trial designs, characters of the subjects, results of the studies were reviewed by two independent authors and analyzed with STATAll. 0 software. Results Compared to TPN, TEN was associated with a significantly 1 ower incidence of pancreatic infection complications （ RR = 0.556,95 % CI： 0.436 ～ 0. 709, P = 0. 000 ）, multiple organ failure （ RR = 0.395,95 % CI： 0.272 - 0.573, P = 0.003 ）, surgical interventions （ RR = 0.556,95 % CI： 0.436 - 0.709, P =0.000） and mortality（RR =0.426,95% CI： O. 238 -0.764,P =0.167）. But TPN was superior to TEN in non-infection complications （RR = 2.697,95% CI： 1. 947 -3. 735, P = 0. 994 ）. Infectioncomplications out of pancreatitis （RR = 0. 853,95 % CI： O. 490 - 1. 483, P = 0. 017 ） had no statistical significance. However, there was no significant difference in length of hospital stay between patients with TPN and TEN. Conclusion TEN might be the preferred nutrition feeding method in patients with acute pancreatitis.
出处
《同济大学学报（医学版）》
CAS
2011年第4期57-62,共6页
Journal of Tongji University(Medical Science)
基金
上海市市级医院新兴前沿技术联合攻关项目(SHDC12010111)
上海市科委重点项目(10149018001)
关键词
急性胰腺炎
肠外营养
肠内营养
META分析
acute pancreatitis
parenteral nutrition
enteral nutrition
meta-analysis
