摘要
目的系统评价持续静脉-静脉血液滤过(continuous veno-venous hemoi ltration,CVVH)为主要方式治疗高脂血症性胰腺炎的有效性和安全性。方法计算机检索h e Cochrane Library(2014第2期)、PubMed、EMbase、CBM、CNKI和WanFang Data,查找有关CVVH治疗高脂血症性胰腺炎的随机对照试验(RCT),检索时限截至2014年2月12日。由2位评价员根据纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5.2软件进行Meta分析。结果最终纳入7个研究,共360例患者,其中CVVH组183例,常规综合治疗组177例。Meta分析结果显示:与常规治疗比较,CVVH能显著降低患者治疗后血脂水平[WMD=–4.63,95%CI(–5.98,–3.27),P<0.000?01]、IL-6水平[WMD=–29.59,95%CI(–34.30,–24.89),P<0.000?01]及总体病死率[RR=0.39,95%CI(0.18,0.84),P=0.02];其APACHE II评分[WMD=–3.34,95%CI(–5.12,–1.56),P=0.000?2]明显低于常规治疗组。结论与常规治疗相比,CVVH治疗高脂血症性胰腺炎更加有效。但受纳入研究数量和质量所限,上述结论尚需今后开展多中心、大样本的高质量RCT加以验证。
Objective To systematically review the effect and safety of continuous veno-venous hemofiltration （CVVH） on patients with hyperlipidemic pancreatitis. Methods Databases including the Cochrane Library （Issue 2, 2014）, PubMed, EMbase, CBM, CNKI and WanFang Data were electronically searched for randomized controlled trials （RCTs） about CVVH on patients with hyperlipidemic pancreatitis till Feb. 12, 2014. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and the methodological quality of included studies was also assessed. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 7 trials met eligibility criteria, involving 360 cases, including 183 cases of CVVH group and 177 cases of control group. The results of meta-analysis showed that compared with only routine medical treatment, CVVH significantly reduced the levels of lipid （WMD= -4.63, 95%CI -5.98 to -3.27, P〈0.000 01）, levels of IL-6 （WMD= -29.59, 95%CI -34.30 to -24.89, P〈0.000 01）, overall mortality （RR=0.39, 95%CI 0.18 to 0.84, P=0.02）, and APACHE II score （WMD= -3.34, 95%CI -5.12 to -1.56, P=0.000 2） after treatment. Conclusion CVVH is more effective for hyperlipidemic pancreatitis than only routine medical treat- ment. Due to the limited quantity and quality of the included studies, further high-quality, multicenter, large-scale RCTs are required to verify the above conclusion.
出处
《中国循证医学杂志》
CSCD
2014年第5期611-617,共7页
Chinese Journal of Evidence-based Medicine
基金
福建省卫生厅青年基金科研课题资助项目(编号:2010-2-30)
