直肠使用吲哚美辛预防内镜逆行胰胆管造影取石术后胰腺炎的Meta分析
发布时间：2018-11-25 07:31
【摘要】：目的评价直肠使用吲哚美辛栓剂预防内镜逆行胰胆管造影取石术后胰腺炎(PEP)的临床疗效,并评估不同时段给药对临床疗效的影响。方法检索PubMed、Web of Science、Cochrane图书馆、相关期刊论文(CNKI)、中国生物医学文献数据库、维普、万方等数据库,并手工检索相关文献,收集直肠使用吲哚美辛栓剂预防PEP的随机对照试验,检索时间从2000年至2016年10月。以PEP发生率、出血并发症发生率为评价指标,采用Jadad评分法进行质量评估,采用Rev Man 5.3软件进行Meta分析。结果纳入符合标准的随机对照试验18项,共4 923例患者,吲哚美辛组PEP发生率低于对照组(RR=0.50,95%CI:0.42~0.60,P0.000 01)。按不同给药时段的亚组分析中,T2组(术前0.5~1 h)、T3组(术前1~2 h)、T4组(术后0.5 h内)和T5组(术后0.5~2 h)PEP发生率均较对照组降低(分别为RR=0.38,95%CI:0.24~0.62,P0.000 1;RR=0.43,95%CI:0.29~0.62,P0.000 01;RR=0.52,95%CI:0.3 7~0.71,P0.0 00 1;RR=0.39,95%CI:0.23~0.65,P=0.000 3)。T1组(术前0.5 h内)和T6组(术中给药)与对照组PEP发生率无显著差异(均P0.05)。吲哚美辛组与对照组的出血并发症发生率无显著差异(P0.05)。结论吲哚美辛栓剂能有效预防PEP,术前0.5~2 h和术后给药吲哚美辛均能减少PEP的发生,而无出血并发症风险的增加。
[Abstract]:Objective to evaluate the clinical efficacy of indomethacin suppository in the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) and to evaluate the effect of indomethacin suppository on the clinical efficacy. Methods PubMed,Web of Science,Cochrane library, full text database of Chinese periodicals, (CNKI), database of Chinese biomedical literature, Weipu, Wanfang and other databases were searched by hand. A randomized controlled trial of rectal indomethacin suppository for the prevention of PEP was conducted from 2000 to 2016. The incidence of PEP and the incidence of hemorrhage complications were used as the evaluation index. The quality was evaluated by Jadad scoring method and Meta analysis by Rev Man 5.3 software. Results the incidence of PEP in indomethacin group was lower than that in control group (RR=0.50,95%CI:0.42~0.60,P0.000 01). According to the subgroup analysis of different administration period, T2 group (0.5 卤1 h), T3 group) (1 h), before operation) The incidence of h) PEP in group T4 (within 0.5 h after operation) and group T5 (0.5 h) PEP after operation) was lower than that in control group (RR=0.38,95%CI:0.24~0.62,P0.000 1, respectively). RR=0.43,95%CI:0.29~0.62,P0.000 01R RRN 0.52 / 95 CI: 0. 3 7 / 0. 71C P0.0 001; The incidence of PEP in T1 group (0.5 h before operation) and T6 group (intraoperative administration) was not significantly different from that in control group (P0.05). There was no significant difference in the incidence of hemorrhage complications between the indomethacin group and the control group (P 0.05). Conclusion Indomethacin suppository can effectively prevent the occurrence of PEP from 0.5 to 2 hours before and after the operation of PEP, without increasing the risk of bleeding complications.
【作者单位】： 暨南大学附属第一医院消化内科;
【分类号】：R576
本文编号：2355300
[Abstract]:Objective to evaluate the clinical efficacy of indomethacin suppository in the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) and to evaluate the effect of indomethacin suppository on the clinical efficacy. Methods PubMed,Web of Science,Cochrane library, full text database of Chinese periodicals, (CNKI), database of Chinese biomedical literature, Weipu, Wanfang and other databases were searched by hand. A randomized controlled trial of rectal indomethacin suppository for the prevention of PEP was conducted from 2000 to 2016. The incidence of PEP and the incidence of hemorrhage complications were used as the evaluation index. The quality was evaluated by Jadad scoring method and Meta analysis by Rev Man 5.3 software. Results the incidence of PEP in indomethacin group was lower than that in control group (RR=0.50,95%CI:0.42~0.60,P0.000 01). According to the subgroup analysis of different administration period, T2 group (0.5 卤1 h), T3 group) (1 h), before operation) The incidence of h) PEP in group T4 (within 0.5 h after operation) and group T5 (0.5 h) PEP after operation) was lower than that in control group (RR=0.38,95%CI:0.24~0.62,P0.000 1, respectively). RR=0.43,95%CI:0.29~0.62,P0.000 01R RRN 0.52 / 95 CI: 0. 3 7 / 0. 71C P0.0 001; The incidence of PEP in T1 group (0.5 h before operation) and T6 group (intraoperative administration) was not significantly different from that in control group (P0.05). There was no significant difference in the incidence of hemorrhage complications between the indomethacin group and the control group (P 0.05). Conclusion Indomethacin suppository can effectively prevent the occurrence of PEP from 0.5 to 2 hours before and after the operation of PEP, without increasing the risk of bleeding complications.
【作者单位】： 暨南大学附属第一医院消化内科;
【分类号】：R576
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