【摘要】 目的：系统评价全胃肠外营养(TPN)和肠内营养(EN)治疗重症急性胰腺炎(SAP)患者的效果。方法：计算机检索SinoMed、CNKI等数据库，检索2010年l月至2013年l2月发表的有关肠内营养治疗重症急性胰腺炎的临床随机对照试验，在对纳入研究进行资料提取及质量评估后，应用RevMan软件对入选文献进行Meta分析。结果:按本评价系统标准，共纳入13篇RCT，合计839例研究对象(422例接受EN治疗，417例接受TPN治疗)。Meta分析结果显示：与TPN相比，EN既能降低人工营养相关并发症的发生率[OR=0．310，95％CI（0.220～0.420），P<0．000 01]，又可降低SAP患者的病死率[OR=0.370，95％CI（0.230～0.590），P<0.000 1]，差异有统计学意义；结论：目前研究提示，对SAP患者进行营养支持，与TPN比较，EN可以降低并发症的发生率及病死率，因此，若条件允许应尽可能及早选择EN进行营养支持。
Destination: To evaluate the effect and safety of Total Parenteral Nutrition(TPN) & Enteral Nutrition(EN) in patients with Severe Acute Pancreatitis(SAP).
Method: Searching Clinical randomized controlled trials during January 2010 to December 2013 of Enteral Nutrition(EN) in patients with Severe Acute Pancreatitis(SAP) in SinoMed and CNKI. Screened the trails according to inclusion and exclusion criteria ,extracted the data and assessed the methodology quality. Meta-analyses were performed using the RevMan software.
Reasult: 13 randomized controlled trails(RCTS) involving 893 patients with SAP were included(422 patients with EN and 417 patients with TPN). The results of Meta-analyses showed that compared with TPN, EN could not only significantly reduce the incident rate of Artificial Nutrition related complications[OR=0.310, 95%CI(0.220~0.420), P<0.0001], but also reduce the fatality rate of patients with SAP[OR=0.370, 95%CI (0.230~0.590), P<0.0001], difference was statistically significant. Conclusion: According to the results, nutrition support for SAP
patients ,compared with TPN, EN could reduce the incidence rate of complications and fatality rate, so, EN should be considered a better choice of nutrition support for SAP patients as soon as possible.