使用预防性抗生素预防急性胰腺炎并发症:临床试验荟萃分析

D. N. Esterini, Kirsten Putriani Hartman, J. A. Trixie, Yessi Setianegari, Kurniyanto Kurniyanto
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引用次数: 0

摘要

背景:急性胰腺炎(AP)是胰腺的一种炎症,是一种没有明确治疗方法的严重急症。它可能发展为感染性坏死,非胰腺炎感染,也可能在最初1至2周内发生死亡。在AP中使用预防性抗生素来预防并发症仍然存在争议。本荟萃分析的目的是评估预防性抗生素治疗预防并发症的益处。方法:通过检索医学数据库确定试验。文学范围在1975年到2021年之间。使用Review Manager 5.4.1对数据提取进行分析,并对纳入研究的偏倚风险进行阐述。以95%可信区间(CI)计算风险比(RR)。P < 0.05认为差异有统计学意义。结果:共分析了20项试验,共1.287例AP患者;646名患者接受抗生素预防治疗,641名患者接受安慰剂治疗。预防性抗生素在两组间存在显著差异。给予预防性抗生素可降低非胰腺感染的风险(RR = 0.77;95% ci: 0.62-0.95;p 0.05)和感染性胰腺坏死(RR = 0.74;95% ci: 0.58-0.94;p 0.05)。同时,预防性抗生素对降低死亡风险的作用不显著(RR = 0.75;95% ci: 0.54-1.03;p 0.05)。结论:预防性抗生素可降低非胰腺感染和感染性胰腺坏死的风险,但不能降低死亡风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Use of Prophylaxis Antibiotics to Prevent Acute Pancreatitis Complications: Meta-Analysis of Clinical Trials
Background: Acute pancreatitis (AP) is an inflammation of the pancreas, a serious emergency with no definitive treatment. It may progress to infected necrosis, non-pancreatitis infection, also death that may occur within the first 1 to 2 weeks. The use of prophylactic antibiotics in AP to prevent complications remains a controversy. The objective of this meta-analysis is to assess the benefit of prophylaxis antibiotics administration to prevent the complication.Method: Trials were identified by searching the medical database. Literature range is within the year 1975 to 2021.  Review Manager 5.4.1 was used to analyse data extraction and risk of bias of included studies were elaborated. Risk ratio (RR) was calculated with 95% confidence interval (CI). P 0.05 was considered significant.Results: Twenty trials with a total of 1.287 patients of AP were analysed; 646 patients treated with antibiotic prophylaxis and 641 patients treated with placebo. Prophylaxis antibiotics were found to have significant difference between the two groups. The administration of prophylaxis antibiotics lower the risk of non-pancreatic infections (RR = 0.77; 95% CI: 0.62–0.95; p 0.05) and infected pancreatic necrosis (RR = 0.74; 95% CI: 0.58-0.94; p 0.05). Meanwhile, prophylaxis antibiotics were found to be insignificant to lower the risk of mortality (RR = 0.75; 95% CI: 0.54-1.03; p 0.05). Conclusion: Prophylaxis antibiotics lower the risk of non-pancreatic infections and infected pancreatic necrosis, but did not lower the risk of mortality.
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