血浆置换治疗高脂血症胰腺炎临床效果的Meta分析 .docVIP

血浆置换治疗高脂血症胰腺炎临床效果的Meta分析 武世文，刘勇坚，周 洁，滕 方，文爱清 （400042重庆，第三军医大学大坪医院野战外科研究所输血科） [摘要] 目的 系统评价血浆置换治疗高脂血症胰腺炎的有效性。方法 计算机检索pubmed、medline、Cochrane Library、2012年8月，并辅以手工检索和文献追溯等方法获取血浆置换治疗高脂血症胰腺炎的相关文献；由2名独立的研究者严格按照Cochrane Reviewers Handbook进行文献筛选、文献评价和数据提取，采用RevMan 5.0软件对数据进行分析。结果 共纳入文献11篇，累计414例患者，其中血浆置换治疗组（PE组）198例，常规综合治疗组（对照组）216例。Meta分析结果显示：与常规治疗组相比，PE组明显提高了总体治愈率[RR=1.48, 95%CI(1.19,1.85), P=0.0005]，缩短了住院时间、禁食时间以及腹痛改善时间，治疗后APACHE II 评分明显低于对照组，但两组总体病死率无统计学差异［RR=0.0, 95%CI(0.29,1.24), P=0.17］PE是高脂血症胰腺炎患者有效的辅助治疗手段。但是目前所获文献方法学质量较低，需要进一步开展高质量、多中心、大样本的RCTs来评价血浆置换治疗高脂血症胰腺炎的有效性和安全性。 [关键词] 血浆置换；胰腺炎；Meta分析；高脂血症 [中图法分类号] [文献标志码] A Effect of plasma exchange on patients with hyperlipidemic pancreatitis: a meta-analysis Wu Shiwen, Liu Yongjian, Zhou Jie, Teng Fang, Wen Aiqing （Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China）[Abstract] Objective To evaluate the efficiency of plasma exchange (PE) on patients with hyperlipidemic pancreatitis. Methods Articles with key words of “plasma exchange or apheresis or pheresis or blood component removal or plasmapheresis” and “pancreatitis” were searched from Pubmed, Medline, Cochrane Library, Chinese Biomedicine Literature Database, CNKI and CQVIP Database from the time of their establishment to August 2012. In addition, grey literatures about plasma exchange on patients with hyperlipidemic pancreatitis were manually searched. Two reviewers screened the literatures, then assessed the quality of each study and extracted data according the Cochrane Collaboration’s method independently. All data were analyzed by using the RevMan5.0 software．Results trials meeting eligibility criteria, involving 414 cases. There were 198 cases of PE group and 216 cases of control group. Meta-analysis showed that PE significantly increased the overall cure rate (RR=1.48, 95%CI=1.19 –1.85, P=0.0005), decreased length of stay, the duration of abdominal pai