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目的评价肠外应用谷氨酰胺治疗重症急性胰腺炎的有效性。方法计算机检索中国生物医学文献数据库、中国知网、PubMed、EMbase及Cochrane图书馆临床对照试验数据库等,查找符合纳入标准的随机对照试验,文献检索时间均从建库截至2013年1月。通过使用由Cochrane协作网推荐的方法,对谷氨酰胺治疗重症急性胰腺炎的随机对照试验进行Meta分析。结果共纳入4篇随机对照试验,190例患者,这些试验均存在统计同质性。谷氨酰胺组比对照组病死率低[OR=0.26,95%CI(0.09,0.73),P=0.01],并发症发生率低[OR=0.41,95%CI(0.22,0.78),P=0.006],住院时间短[WMD=-4.85 d,95%CI(-6.67,-3.03)d,P<0.000 01]。结论据目前的证据,谷氨酰胺对于重症急性胰腺炎有效。
Objective To evaluate the effectiveness of parenteral glutamine in the treatment of severe acute pancreatitis. Methods A computer-controlled search of China Biomedical Literature Database, CNKI, PubMed, EMbase and the Cochrane Central Register of Controlled Clinical Trials database was conducted to search for randomized controlled trials that met the inclusion criteria. The search time was from January to January 2013. Meta-analysis was performed on randomized controlled trials of glutamine for severe acute pancreatitis using the methods recommended by the Cochrane Collaboration. Results A total of 4 randomized controlled trials were included and 190 patients were statistically homogenous. The mortality rate in the glutamine group was lower than that in the control group [OR = 0.26, 95% CI (0.09, 0.73), P = 0.01] and the complication rate was low [OR = 0.41,95% CI (0.22,0.78, P = 0.006], and shorter hospital stay [WMD = -4.85 d, 95% CI (-6.67, -3.03) d, P <0.000 01]. Conclusion According to the current evidence, glutamine is effective in severe acute pancreatitis.