摘要目的 评价静脉抗氧化剂治疗中度重症急性胰腺炎(MSAP)和重症急性胰腺炎(SAP)的疗效.方法 采用计算机和手工方法检索PubMed、EMbase、Cochrane Database和CNKI数据库,检索时间截至2016年3月18日.收集静脉抗氧化物治疗MSAP和SAP的临床随机对照研究.纳入数据为胰腺炎相关病死率及住院天数.采用Cochrane系统评价法评价纳入文献的质量.结果 最终纳入15项研究,共620名患者,其中5篇文献提供了详细的随机分配方案,1篇文献随机分配方案存在高度偏倚.在结局指标的评估是否采用盲法、结果数据报告是否完整、研究结果报告是否存在选择性方面,3篇文献存在不详及高度偏倚.未发现其他偏倚.分析结果显示,与对照组比较,静脉抗氧化剂治疗MSAP和SAP不影响患者的病死率(12.1％比9.7％,RD=-0.02,95％ CI-0.08～-0.03,P=0.44;RR =0.83,95％ CI0.51～1.34,P=0.44),但可显著缩短患者的住院天数(MD=-2.02,95％ CI-4.00～-0.05,P=0.04).结论 静脉抗氧化剂治疗可以显著缩短MSAP和SAP患者的住院天数.

abstractsObjective To investigate the efficacy of intravenous antioxidants therapy in treating moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP).Methods Pubmed,Embase,Cochrane library and CNKI databases for all randomized control trials published before March 18st,2016 manually was searched by computer.Data on AP associated mortality and length of stay (LOS) were collected.The quality of the trials included was assessed by the Cochrane systematic review method.Results Fifteen trials with data of 620 patients were eligible for final inclusion.Among the 15 trials,detailed randomization for grouping was clearly described in 5 studies and obvious bias was observed in 1 study.Three studies had obvious biases considering whether outcome assessment was blinded,outcome data was incomplete and outcome report was selective.No other apparent bias was found.Statistical analysis showed that compared with control group,intravenous antioxidants administration did not significantly reduce mortality (12.1 vs 9.7,RD=-0.02,95％ CI-0.08～-0.03,P=0.44;RR=0.83.95％ CI0.51～ 1.34,P=0.44),but could shorten LOS (MD=-2.02;95％ CI-4.00～-0.05;P=0.04).Conclusions Intravenous antioxidants could greatly shorten LOS of patients with MSAP and SAP.