糖皮质激素预防ERCP术后胰腺炎的Meta分析

被引：10

作者：

袁文明

李静

徐琳

张小利

机构：

[1] 四川大学华西医院循证医学与临床流行病学教研室

来源：

解放军医学杂志 | 2007年 / 08期

关键词：

糖皮质激素类; 胰胆管造影术，内窥镜逆行; 胰腺炎; Meta;

D O I：

暂无

中图分类号：

R619 [手术前后的处理及外科并发症];

学科分类号：

100120 [医学发育生物学];

摘要：

目的评价糖皮质激素预防内窥镜逆行胰胆管造影术(ERCP)后胰腺炎(PEP)的疗效和安全性。方法计算机检索Cochrane图书馆(issue 4,2006)、Medline(1966～2007.1)、EMBASE(1986～2007.1)和中国生物医学文献数据库(1978～2007.1),手检消化内科相关杂志(2006.7～2007.1)和参考文献,纳入糖皮质激素预防ERCP术后胰腺炎的随机对照试验,由两人独立进行数据提取和文献评价。应用RevMan4.2.8进行统计分析。结果共纳入6篇文献,Meta分析显示两组ERCP术后胰腺炎发生率无统计学差异(RR=1.11,95%CI 0.89～1.39)。亚组分析显示两组术后轻中度和重度胰腺炎发生率均无统计学差异(轻中度RR=1.17,95%CI 0.91～1.51;重度RR=1.79,95%CI 0.69～4.65;纳入4篇文献)。两组治疗性ERCP术后胰腺炎的发生率无统计学差异(RR=1.24,95%CI 0.91～1.67;纳入3篇文献)。排除3篇中止试验后的Meta分析同样显示两组术后胰腺炎发生率无统计学差异(RR=0.73,95%CI 0.44～1.20)。结论当前研究显示,糖皮质激素不能减少ERCP术后胰腺炎的发生,需要进一步高质量的研究来揭示糖皮质激素与对预防ERCP术后胰腺炎的关系。

引用

页码：805 / 807

页数：3

共 9 条

[1]

Pharmacological prevention of serious anaphylactic reactions due to iodinated contrast media: systematic review[J] Martin R Tramèr;Erik von Elm;Pierre Loubeyre;Conrad Hauser BMJ: British Medical Journal 2006,

[2]

The sirens are singing: The perils of trusting trials stopped early and subgroup analyses[J] Claudio M. Martin;Gordon Guyatt;Victor M. Montori Critical Care Medicine 2005,

[3]

Complications of ERCP[J] J.Shawn Mallery;Todd H. Baron;Jason A. Dominitz;Jay L. Goldstein;William K. Hirota;Brian C. Jacobson;Jonathan A. Leighton;Hareth M. Raddawi;John J. Varg;J.Patrick Waring;Robert D. Fanelli;Jo Wheeler-Harbough;Glenn M. Eisen;Douglas O. Faigel Gastrointestinal Endoscopy 2003,

[4]

Post-Randomisation Exclusions: The Intention To Treat Principle And Excluding Patients From Analysis[J] Dean Fergusson;Shawn D. Aaron;Gordon Guyatt;Paul Hébert BMJ: British Medical Journal 2002,

[5]

A Prospective; Randomized; Placebo-Controlled Trial of Prednisone and Allopurinol in the Prevention of ERCP-Induced Pancreatitis[J] A. Budzyńska;T. Marek;A. Nowak;R. Kaczor;E. Nowakowska-Dulawa Endoscopy 2001,

[6]

Systematic Reviews In Health Care: Assessing The Quality Of Controlled Clinical Trials[J] Peter Jüni;Douglas G. Altman;Matthias Egger BMJ: British Medical Journal 2001,

[7]

Risk factors for post-ERCP pancreatitis: A prospective; multicenter study[J] Martin L. Freeman;James A. DiSario;Douglas B. Nelson;M.Brian Fennerty;John G. Lee;David J. Bjorkman;Carol S. Overby;Johannes Aas;Michael E. Ryan;Gary S. Bochna;Michael J. Shaw;Harry W. Snady;Robert V. Erickson;Joseph P. Moore;Joseph P. Roel Gastrointestinal Endoscopy 2001,

[8]

Use of corticosteroids in the prevention of post-ERCP pancreatitis: results of a controlled prospective study[J] Giovanni D De Palma;Carlo Catanzano The American Journal of Gastroenterology 1999,

[9]

Use of corticosteroids in the prevention of post-ERCP pancreatitis[J] Gareth R. Weiner;Joseph E. Geenen;Walter J. Hogan;Marc F. Catalano Gastrointestinal Endoscopy 1995,

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