坏死性胰腺炎中的预防性抗生素：一项荟萃分析。
Prophylactic antibiotics in necrotizing pancreatitis: a meta-analysis.
作者信息
Hart Phil A, Bechtold Matthew L, Marshall John B, Choudhary Abhishek, Puli Srinivas R, Roy Praveen K
机构信息
Division of Gastroenterology, University of Missouri School of Medicine, Columbia, MO 65212, USA.
出版信息
South Med J. 2008 Nov;101(11):1126-31. doi: 10.1097/SMJ.0b013e31817ecbda.
PURPOSE
Prophylactic antibiotics have been used in acute necrotizing pancreatitis with mixed results. This meta-analysis analyzes the effects of prophylactic antibiotics in necrotizing pancreatitis.
METHODS
Multiple databases and abstracts were searched for randomized trials comparing treatment with prophylactic antibiotics to treatment without prophylactic antibiotics in necrotizing pancreatitis. Prophylactic antibiotics' effects were analyzed by calculating pooled estimates of mortality, infected pancreatic necrosis, length of hospital stay, nonpancreatic infections, and surgical intervention.
RESULTS
Seven studies (n = 429) met the inclusion criteria. Prophylactic antibiotics for acute necrotizing pancreatitis significantly decreased the length of hospital stay (P = 0.04) and the rate of nonpancreatic infections (P < 0.01). No significant differences were noted for mortality (P = 0.22), infected necrosis (P = 0.18), and surgical intervention (P = 0.40).
CONCLUSIONS
Prophylactic antibiotics in necrotizing pancreatitis reduced the length of hospital stay and rate of nonpancreatic infections but did not decrease mortality, infected necrosis, or surgical intervention.
目的
预防性抗生素已用于急性坏死性胰腺炎，但其效果不一。本荟萃分析旨在分析预防性抗生素在坏死性胰腺炎中的作用。
方法
检索多个数据库及摘要，查找关于坏死性胰腺炎中比较预防性抗生素治疗与非预防性抗生素治疗的随机试验。通过计算死亡率、感染性胰腺坏死、住院时间、非胰腺感染及手术干预的合并估计值，来分析预防性抗生素的效果。
结果
七项研究（n = 429）符合纳入标准。急性坏死性胰腺炎使用预防性抗生素可显著缩短住院时间（P = 0.04）并降低非胰腺感染率（P < 0.01）。在死亡率（P = 0.22）、感染性坏死（P = 0.18）及手术干预（P = 0.40）方面未发现显著差异。
结论
坏死性胰腺炎使用预防性抗生素可缩短住院时间并降低非胰腺感染率，但并未降低死亡率、感染性坏死或手术干预率。
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