摘要
目的评价血液净化治疗急性重症胰腺炎(SAP)的有效性和安全性。方法通过中国期刊全文数据库(CNKI),万方数据库,维普数据库等数据库及论文集检索相关文献。依据检索策略收集资料,按纳入标准筛选文献,主要对病死率,APACHEII评分,住院时间,炎症介质等指标进行Meta分析。结果共纳入符合标准的12篇随机对照研究,涉及699例患者,其中血液净化组352例,常规非手术治疗组347例,荟萃分析结果显示:与常规非手术治疗组相比,血液净化治疗组明显降低了病死率[OR=0.37,95%CI为(0.23～0.60),P<0.0001];显著改善了APACHEII评分;缩短了住院时间,更加有效清除了C反应蛋白(CRP),血白细胞计数(WBC),肿瘤坏死因子-α(TNF-α),白介素-6(IL-6)等炎症介质,且差异均有统计学意义(P<0.05)。结论血液净化治疗在急性重症胰腺炎中是有效的,但国内研究方法学质量偏低,需要进一步多中心的大样本的高质量的临床试验研究来评价血液净化治疗在SAP中的有效性和安全性。
Objective To evaluate the effect and safety of blood purification in patients with severe acute pancreatitis. Methods Through Meta analysis in Chinese clinical trials, all previously published or unpublished studies were comprehensively searched in the database such as CNKI , CHINAINFO,VIP . The Meta analysis involved mortality rate, the scores of acute physiology and chronic health evaluation II （APACHEII）, hospitalization time, inflammatory factor and so on. Results The Meta analysis included 12 articles which were accordance with the criteria, involved699 patients, including 352 patients of blood purification and 347 patients of ordinary non-operation treatment. The Meta analysis showed that blood purification significantly decreased the mortality rate[OR=0.37,95%CI was（0.23～0.60）,P〈0.0001], improved APACHEII scores, shortened hospitalization time, reduced CRP, WBC, TNF-α and IL-6, compared with the normal non-operation treatment. Conclusion Blood purification in patients with severe acute pancreatitis was effective , but further high-quality, large-scale, randomized controlled trails should be performed to evaluate the effect and safety in patients with severe acute pancreatitis.
出处
《创伤与急危重病医学》
2014年第1期42-47,共6页
Trauma and Critical Care Medicine
