Meta-analysis: Total Parenteral Nutrition Versus Total Enteral Nutrition in Predicted Severe Acute Pancreatitis
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概要
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Background Total parenteral nutrition (TPN) as a traditional mode of treatment in severe acute pancreatitis was still used widely in clinical work. In addition, enteral nutrition treatment methods have developed; early enteral nutrition has already been highlighted for severe acute pancreatitis, but the therapeutic risks versus benefits need to be studied. Aims and Objective To compare total parenteral nutrition with total enteral nutrition (TEN) in patients with severe acute pancreatitis by performing a meta-analysis. Materials and Methods Electronic databases including PubMed, EMBASE, Science Citation Index, were searched to find relevant randomized controlled trials. Two reviewers independently identified relevant trials evaluating the effect of total parenteral nutrition and early enteral nutrion. Outcome measures were the mortality, hospital length of stay, infectious complications, duration of nutrition, organ failure and surgical intervention. Results Eight randomized controlled trials (RCTs) including 381 patients were identified. Meta-analysis demonstrated that TEN was significantly superior to TPN when considering mortality [p=0.001, 95%CI 0.37(0.21-0.68)], infectious complications [p=0.004, 95%CI 0.46(0.27-0.78)], organ failure [p=0.02, 95%CI 0.44(0.22-0.88)] and surgical intervention [p=0.003, 95%CI 0.41(0.23-0.74)].While no difference between TEN and TPN when considering the hospital length of stay [p=0.22, 95%CI -14.10(-36.48-8.26)] and as for duration of nutrition [p=0.72, 95%CI -1.50(-9.56-6.56)] there was not enough data to compare the differences. Conclusion Total enteral nutritional support is associated with lower mortality, fewer infectious complications, decreased organ failure and surgical intervention rate compared to parenteral nutritional support.
著者
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Zhao Jie
Department Of Chemistry Faculty Of Engineering Yamagata University:department Of Applied Chemistry N
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Zhou Feng
Department Of Anatomy And Cell Biology And Medical Neurobiology Program Indiana University School Of
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Xia Bing
Department Of Internal Medicine Zhongnan Hospital Of Wuhan University
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Zhao Jie
Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, China
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Yi Fengming
Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, China
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Ge Liuqing
Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, China
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Lei Yuan
Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, China
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Chen Zhifen
Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, China
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Zhu Youqing
Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, China
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Zhou Feng
Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, China
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