Horibe Masayasu, Nishizawa Toshihiro, Suzuki Hidekazu, Minami Kazuhiro, Yahagi Naohisa, Iwasaki Eisuke, Kanai Takanori
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine.
Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School Of Medicine.
United European Gastroenterol J. 2016 Dec;4(6):725-732. doi: 10.1177/2050640615612368. Epub 2015 Oct 13.
The optimal timing of oral refeeding in acute pancreatitis is unclear. This study aimed to perform a systematic review with meta-analysis of randomized controlled trials (RCTs) that compared early oral refeeding with standard oral refeeding in acute pancreatitis.
PubMed, the Cochrane library, and the Igaku-Chuo-Zasshi database were searched in order to identify RCTs eligible for inclusion in the systematic review. The weighted mean differences (WMDs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.
Five eligible RCTs were included. Compared with standard oral refeeding, early oral refeeding significantly decreased the length of hospital stay (WMD: -2.22, 95%CI: -3.37 to -1.08, = 0.0001). Although there was heterogeneity (= 56%, = 0.06), subgroup analysis of the refeeding criteria (immediate group and hungry group) eliminated the heterogeneity. There was no significant difference between the early refeeding group and standard refeeding groups with respect abdominal pain and distension (OR 1.14; 95%CI 0.65-1.99 and OR 1.53; 95%CI 0.81-2.90).
Compared with standard oral refeeding, early oral refeeding safely reduced the length of hospital stay in patients with acute pancreatitis.
急性胰腺炎口服再喂养的最佳时机尚不清楚。本研究旨在对比较急性胰腺炎早期口服再喂养与标准口服再喂养的随机对照试验（RCT）进行系统评价和荟萃分析。
检索PubMed、Cochrane图书馆和医学中央杂志数据库，以确定符合纳入系统评价标准的RCT。计算加权平均差（WMD）或比值比（OR）及95%置信区间（CI）。
纳入5项符合条件的RCT。与标准口服再喂养相比，早期口服再喂养显著缩短了住院时间（WMD：-2.22，95%CI：-3.37至-1.08，P = 0.0001）。尽管存在异质性（I² = 56%，P = 0.06），但对再喂养标准（即刻组和饥饿组）进行亚组分析消除了异质性。早期再喂养组与标准再喂养组在腹痛和腹胀方面无显著差异（OR 1.14；95%CI 0.65 - 1.99和OR 1.53；95%CI 0.81 - 2.90）。
与标准口服再喂养相比，早期口服再喂养可安全缩短急性胰腺炎患者的住院时间。
