内镜下鼻胆管引流术预防经内镜胰胆管造影术后胰腺炎及高淀粉酶血症Meta分析.docVIP

内镜下鼻胆管引流术预防经内镜胰胆管造影术后胰腺炎及高淀粉酶血症Meta分析 　　[摘要] 目的 系统评价术后预防性放置鼻胆管引流术（ENBD）对经内镜逆行胰胆管造影术后胰腺炎（PEP）及高淀粉酶血症的有效性及安全性。 方法 计算机检索PubMed、Medline、EMBASE、CBM、CNKI及WanFang Data，检索时限从建库至2014年2月24日，全面收集ENBD预防PEP的随机对照试验。由2位评价者按照纳入和排除标准独立选择文献、提取资料和评价质量后，采用RevMan 5.2软件进行Meta分析。 结果 共纳入14个临床对照研究，3143例拟行ERCP术的患者。Meta分析结果显示：观察组和对照组术后PEP发生率比较差异有统计学意义[OR = 0.25，95%CI：0.17～0.36，P 0.000 01]，两组术后24 h血清淀粉酶水平比较差异有统计学意义[OR = 0.33，95%CI：0.23～0.46，P 0.000 01]，内镜下鼻胆管引流术能减少术后胰腺炎和高淀粉酶血症的发生率。 结论 术后预防性放置鼻胆管引流可以有效降低ERCP术后胰腺炎及高淀粉酶血症的发生率。但因原始研究的质量限制，需要更多大样本、高质量、设计严谨的随机对照试验论证以上结论。 　　[关键词] 内镜下鼻胆管引流；内镜下逆行性胰胆管造影；Meta分析 　　[中图分类号] R572.2 [文献标识码] A [文章编号] 1673-7210（2014）10（a）-0043-05 　　Endoscopic nasobiliary drainage for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia： a Meta-analysis 　　LI Wei YU Honggang MU Ganggang 　　Department of Gastroenterology， Renmin Hospital of Wuhan University， Hubei Province， Wuhan 430060， China 　　[Abstract] Objective To systematically review the effectiveness and safety of endoscopic nasobiliary drainage in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP） and hyperamylasemia. Methods Electronic searches were conducted to connect randomized controlled trials comparing ENBD to placebo in the prevention of PEP from the PubMed， Medline， EMBASE， CBM， CNKI and WanFang Data. All ISI were searched from their establishment to February 24， 2014. According to the inclusion and exclusion criteria， literature identification， data extraction， and quality assessment were performed by two reviewers independently. Then， RevMan 5.2 software was used for Meta-analysis. Results A total of 14 randomized controlled trials involving 3143 patients were included. The Meta-analysis showed that incidence of PEP between obsenvation group and control group was statistically significant （OR = 0.11， 95%CI： 0.05-0.27， P 0.000 01）， incidence of hyperamylasemia was statistically significant （OR = 0.27， 95%CI： 0.18-0.42， P 0.000 0