中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2012年
6期
363-368
,共6页
急性胰腺炎%肠内营养%全胃肠外营养%营养时间%荟萃分析
急性胰腺炎%腸內營養%全胃腸外營養%營養時間%薈萃分析
급성이선염%장내영양%전위장외영양%영양시간%회췌분석
Acute pancreatitis%Enteral nutrition%Total parenteral nutrition%Nutrition time%Meta-analysis
目的 探讨并对比不同时间开始的肠外营养与肠内营养对急性胰腺炎的影响.方法 在MEDLINE、EMBASE、Cochrane图书馆、万方期刊库和中国期刊网检索1966年1月至2011年1月发表的有关全胃肠外营养和肠内营养治疗急性胰腺炎的随机对照研究.由2名评价者对入选研究的研究设计、研究对象的特征、研究结果等内容独立进行摘录,采用RevMan4.2软件进行分析.结果 有14项研究纳入本研究.本研究结果显示,入院24h后,与全胃肠外营养相比,肠内营养能显著降低感染(P=0.0004)、手术(P=0.0200)、器官衰竭(P=0.0400)及死亡率(P=0.0002)；入院48h内,与全胃肠外营养相比,肠内营养能显著降低感染(P =0.0000)、手术(P=0.0001)、器官衰竭(P=0.0006)及死亡率(P =0.0300).结论 肠内营养的疗效可能受营养开始时间的限制,急性胰腺炎患者入院24～48h开始肠内营养优于入院24 h内或48h后开始.
目的 探討併對比不同時間開始的腸外營養與腸內營養對急性胰腺炎的影響.方法 在MEDLINE、EMBASE、Cochrane圖書館、萬方期刊庫和中國期刊網檢索1966年1月至2011年1月髮錶的有關全胃腸外營養和腸內營養治療急性胰腺炎的隨機對照研究.由2名評價者對入選研究的研究設計、研究對象的特徵、研究結果等內容獨立進行摘錄,採用RevMan4.2軟件進行分析.結果 有14項研究納入本研究.本研究結果顯示,入院24h後,與全胃腸外營養相比,腸內營養能顯著降低感染(P=0.0004)、手術(P=0.0200)、器官衰竭(P=0.0400)及死亡率(P=0.0002)；入院48h內,與全胃腸外營養相比,腸內營養能顯著降低感染(P =0.0000)、手術(P=0.0001)、器官衰竭(P=0.0006)及死亡率(P =0.0300).結論 腸內營養的療效可能受營養開始時間的限製,急性胰腺炎患者入院24～48h開始腸內營養優于入院24 h內或48h後開始.
목적 탐토병대비불동시간개시적장외영양여장내영양대급성이선염적영향.방법 재MEDLINE、EMBASE、Cochrane도서관、만방기간고화중국기간망검색1966년1월지2011년1월발표적유관전위장외영양화장내영양치료급성이선염적수궤대조연구.유2명평개자대입선연구적연구설계、연구대상적특정、연구결과등내용독립진행적록,채용RevMan4.2연건진행분석.결과 유14항연구납입본연구.본연구결과현시,입원24h후,여전위장외영양상비,장내영양능현저강저감염(P=0.0004)、수술(P=0.0200)、기관쇠갈(P=0.0400)급사망솔(P=0.0002)；입원48h내,여전위장외영양상비,장내영양능현저강저감염(P =0.0000)、수술(P=0.0001)、기관쇠갈(P=0.0006)급사망솔(P =0.0300).결론 장내영양적료효가능수영양개시시간적한제,급성이선염환자입원24～48h개시장내영양우우입원24 h내혹48h후개시.
Objective To compare the effect of parenteral nutrition and enteral nutrition with different start time on acute pancreatitic patients.Methods Randomized controlled trials comparing enteral and parenteral nutrition in acute pancreatitic patients published from January 1996 to January 2011 were searched in MEDLINE,EMBASE,Cochrane databases,Wanfang science library,and China National Knowledge Infrastructure.The information about study design,patient characteristics,and outcomes were extracted by two independent analysers before processed with RevMan 4.2 software.Results Altogether 14 trials were included.When started after 24 hours of admission,enteral nutrition,in comparison with total parenteral nutrition,resulted in a statistically significant reduction in the risks of infections (P =0.0004),surgical intervention (P =0.0200),organ failure (P =0.0400),and morality (P =0.0002) in acute pancreatitic patient.When started within 48 hours of admission,enteral nutrition,in comparison with total parenteral nutrition,resulted in a statistically significant reduction in the risks of infections (P =0.0000),surgical intervention (P =0.0001),organ failure (P =0.0006),and mortality (P =0.0300) in acute pancreatitic patients.Conclusions The time of the commencement of nutriton has an influence on the benefits of enteral nutrition.Enteral nutrition started between 24 hours and 48 hours of admission is more effective than within 24 hours or after 48 hours of admission.
