妊娠期急性胰腺炎1例的循证治疗探讨

Evidence based treatment for an acute pancreatitis patient in pregnancy

目的借助循证医学的方法为1例妊娠合并胰腺炎的患者确定一个合理安全的治疗方案。方法在充分评估患者情况后,提出临床问题,从Cochrane图书馆(2008年第4期)、Medline(pubmed网站1990-01～2008-12)和http://www.guideline.gov/检索,检索主题词为:Acute pancreatitis;in pregnancy;Antibiotic therapy;Somatostatin;Endoscopic retrograde holangiopancreatography(ERCP);enteral nutrition or paremeral nutrition;RCT;Meta-analysis review;pracrtice Guideline。结果共检索出与不同问题相关的随机对照试验14篇,系统评价或Meta分析32篇;通过对检索结果进行了分析,为患者制定合理安全的治疗方案。结论采用循证治疗的方法,为妊娠合并胰腺炎患者确定合理安全的治疗方案,可取得较佳治疗效果。

Objective To apply the methods of evidence based medicine to making an individualized and safe treatment plan to treat an panereatitis patient in pregnancy. Methods After clinical problems were put forward, evidence was collected from Issue 4,2008, Cochrane library, Medline and http：//www, guideline, gov/. According to the search strategy subject words were：acute pancreatitis in pregnancy;Antibiotic therapy; Somatostatin; Endoscopie retrograde （ERCP） ; enteral nutrition or parenteral nutrition; RCT; Meta-analysis review; pracrtice Guideline. Results A total of 14 RCTs, and 32 systematic reviews were identified. A rational and safe treatment plan was made through a serious evaluation of the data. After the ERCP ＋ EST, it was proved that the plan was optimal. Conclusion The treatment efficacy can improved by determining an individualized treatment plan according to evidence based methods.