生长抑素类似物对胰腺手术后术后结局的影响：一项荟萃分析。
The effect of somatostatin analogues on postoperative outcomes following pancreatic surgery: A meta-analysis.
机构信息
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Department of Vascular Surgery, Wuhan Central Hospital, Tongji Medical College, Huazhong University of science and Technology, Wuhan, China.
出版信息
PLoS One. 2017 Dec 6;12(12):e0188928. doi: 10.1371/journal.pone.0188928. eCollection 2017.
BACKGROUND
Leakage from the pancreatic stump is a leading cause of morbidity following pancreatic surgery. It is essential to evaluate the effect of somatostatin analogues (SAs) following pancreatic surgery by analyzing all recent clinical trials.
DATA SOURCES
We performed a literature search in the Medline, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science databases up to May 29, 2016. Publication bias was assessed with Egger's test. Study quality was assessed using the Jadad Composite Scale.
CONCLUSIONS
Twelve clinical trials involving 1703 patients from Jan 1st, 2000 to May 29th, 2016 were included in the study. With improvements in surgical management and peri-operative patient care, prophylactic use of somatostatin and its analogues reduced the overall incidence of pancreatic fistulas (RR 0.72, 95% CI 0.55-0.94; p = 0.02) and decreased the post-operative hospital stay after pancreatic surgery (the weighted mean difference was -1.06, 95% CI-1/88 to -0.23; p = 0.01). Other post-operative outcomes did not change significantly with the use of somatostatin analogues.
背景
胰瘘是胰腺手术后发生并发症的主要原因。通过分析所有最新的临床试验来评估生长抑素类似物（SAs）在胰腺手术后的效果至关重要。
资料来源
我们在 Medline、EMBASE、Cochrane 对照试验中心注册库和 Web of Science 数据库中进行了文献检索，检索时间截至 2016 年 5 月 29 日。采用 Egger 检验评估发表偏倚。使用 Jadad 综合量表评估研究质量。
结论
本研究共纳入 2000 年 1 月 1 日至 2016 年 5 月 29 日的 12 项临床试验，共涉及 1703 例患者。随着手术管理和围手术期患者护理的改善，预防性使用生长抑素及其类似物降低了胰腺瘘的总体发生率（RR 0.72，95%CI 0.55-0.94；p = 0.02），并缩短了胰腺手术后的住院时间（加权均数差值为-1.06，95%CI-1/88 至-0.23；p = 0.01）。生长抑素类似物的使用并未显著改变其他术后结局。
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