Gastroenterology Unit of Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.
Dig Dis Sci. 2022 Aug;67(8):4131-4139. doi: 10.1007/s10620-021-07269-8. Epub 2021 Oct 11.
Fluid therapy plays a critical role in the management of acute pancreatitis. Normal saline (NS) is commonly used in these patients. However, Lactate Ringer's (LR) has also been shown to be useful for this condition.
To assess the effect of LR compared to NS in patients with acute pancreatitis.
We searched in three electronic databases from inception to December 2020 for randomized controlled trials (RCTs). Outcomes were mortality, intensive care unit (ICU) admission, hospital stay, and Systemic Inflammatory Response Syndrome (SIRS) at 24, 48, and 72 h. The risk of bias was assessed using the Risk of Bias 2.0 tool. All meta-analyses were performed using a random-effects model.
Four RCTs comprising 248 patients were included. The mean age ranged from 42.3 to 63.8 years and 49% of patients were men. Patients treated with LR had similar risk of mortality (risk ratio [RR], 0.53; 95% confidence interval [CI], 0.09-3.00) and SIRS at 24 h (RR, 0.69; 95% CI, 0.32-1.51), 48 h (RR, 0.80; 95% CI, 0.46-1.41), and 72 h (RR, 0.68; 95% CI, 0.37-1.25) compared to NS. LR had significantly lower hospital stay (mean difference, - 1.10; 95% CI, - 1.92 to - 0.28) and lower risk of ICU admission (RR, 0.42; 95% CI, 0.20-0.89) compared to NS. The risk of bias was low in nearly all RCTs.
No differences were found in the mortality and SIRS at 24, 48, and 72 h in patients treated with LR and NS. In contrast, patients who received LR had a lower risk of ICU admission and lower hospital stay than NS.
液体疗法在急性胰腺炎的治疗中起着关键作用。生理盐水（NS）通常用于此类患者。然而，乳酸林格氏液（LR）也已被证明对该病症有效。
评估 LR 与 NS 在急性胰腺炎患者中的疗效比较。
我们从三个电子数据库中检索了从成立到 2020 年 12 月的随机对照试验（RCT）。结局指标为死亡率、重症监护病房（ICU）入住率、住院时间和 24、48 和 72 小时的全身炎症反应综合征（SIRS）。使用风险偏倚 2.0 工具评估偏倚风险。所有的荟萃分析均采用随机效应模型进行。
纳入了四项 RCT 共计 248 例患者。患者的平均年龄范围为 42.3 岁至 63.8 岁，其中 49%为男性。与 NS 相比，LR 治疗组患者的死亡率（风险比 [RR]，0.53；95%置信区间 [CI]，0.09-3.00）和 24 小时 SIRS（RR，0.69；95%CI，0.32-1.51）、48 小时 SIRS（RR，0.80；95%CI，0.46-1.41）和 72 小时 SIRS（RR，0.68；95%CI，0.37-1.25）无显著差异。LR 组的住院时间明显缩短（平均差值，-1.10；95%CI，-1.92 至-0.28），ICU 入住率也低于 NS 组（RR，0.42；95%CI，0.20-0.89）。几乎所有的 RCT 风险偏倚都较低。
LR 与 NS 治疗的患者在 24、48 和 72 小时的死亡率和 SIRS 无显著差异。相比之下，LR 组患者的 ICU 入住率和住院时间均低于 NS 组。
