预防性使用抗生素能降低重症急性胰腺炎的死亡率 - 第三军医大学学报.doc

预防性使用抗生素治疗急性坏死性胰腺炎的作用——Meta分析 饶春燕1，胡昌伦2，赵晓晏1* 第三军医大学新桥医院消化内科，重庆，400037 武警重庆总队医院内分泌科，重庆，400061 摘要 目的 评价预防性使用抗生素对治疗急性坏死性胰腺炎（acute necrotizing pancreatitis，ANP）的作用。 方法 在Medline、Pubmed、Springer、Ovid、Elsevier、Embase、CNKI、维普数据库中，检索1994年1月至2011年10月发表的文献。按入选标准，最终纳入5篇文献，使用RevMan5.0进行统计分析。 结果 预防性使用抗生素治疗急性坏死性胰腺炎与对照组相比，并不能显著改善生存率（RR 0.75，95%CI 0.43-1.28，p=0.29），也不能降低胰腺感染（RR 0.81，95%CI 0.55-1.19，p=0.29）、胰外感染（RR 0.79，95%CI 0.59-1.06，p=0.12）及手术干预（RR 0.78，95%CI 0.45-1.36，p=0.37）等并发症的发生几率。 结论 对于预防性使用抗生素治疗急性坏死性胰腺炎，根据现有的随机对照治疗尚不能说明起可以显著降低病死率和减少并发症的发生。 关键词：预防性抗生素，随机对照，急性坏死性胰腺炎 Role of Prophylactic Antibiotics for Acute Necrotizing Pancreatitis——A Meta-Analysis Chunyan Rao1, Changlun Hu2, Xiaoyan Zhao1* Department of Gastroenterology, Xiaoqiao Hospital, Third Military Medical University, Chongqing 400037, China Department of Endocrinology, Chongqing Corps Hospital of Chinese People′s Armed Police Forces, Chongqing 40061, China Abstract Objective: To evaluate the role of prophylactic antibiotics for acute necrotizing pancreatitis via Meta analysis. Methods: A computerized literature search was conducted using Medline, Pnbmed, Spring, Ovid, Elsevier, Embase, CNKI, VIP for relevant articles published from January 1994 to October 2011. According to the inclusion criteria, 5 studies were selected, and using Revman 5.0 software analyzed the data. Result: Analysis suggested that prophylactic antibiotic treatment was not significantly reduced morbility(RR 0.75，95%CI 0.43-1.28，p=0.29), or infected pancreatic necrosis(RR 0.81，95%CI 0.55-1.19，p=0.29), nonpancreatic infection(RR 0.79，95%CI 0.59-1.06，p=0.12), surgical intervention(RR 0.78，95%CI 0.45-1.36，p=0.37). Conclusion: According to the achieved randomized controlled trials, prophylactic antibiotic treatment did not reduced occurrence of infected pancreatic necrosis, nonpancreatic infection, surgical intervention or morbility in patients w ith acute necrotizing pancreatitis. Key words: Prophylactic antibiotic, Randomized controlled