生长抑素预防胰腺手术后胰瘘的Meta分析

摘要

目的:评价生长抑素是否可以降低胰腺手术后胰瘘的发生风险.方法:检索Pubmed(1966年1月-2012年11月)、EMBASE(1974年1月-2012年12月)、CENTRAL (2012年第4期)、中国期刊全文数据库(CNKI 1994年3月-2012年1 2月)以及美国临床肿瘤学会(ASCO)、欧洲肿瘤协会(EM-SO)官方网公开发表的关于生长抑素应用预防胰腺手术后胰瘘的临床随机对照研究(RCTs).应用Stata 11.0统计软件分析生长抑素组与对照组患者术后胰瘘发生率有无差别.结果:共15项研究纳入分析,其中生长抑素组纳入1089例患者,术后发生胰瘘者141例；对照组1 035例,共241例患者发生胰痿.Meta分析结果显示预防性应用生长抑素组患者术后胰痿发生风险明显小于对照组(RR=0.63,95％CI:0.47～0.86,P=0.003).结论:胰腺手术后预防性生长抑素可显著降低胰腺手术后胰瘘的发生风险.%Objective:To evaluate whether the prophylactic ues of octreotide can reduce the risk of postoperative pancreatic fistula in patients treated with pancreatic surgery.Methods:By searching PubMed (from Jan,1966 to Nov,2012),CENTRAL (the Cochrane central register of controlled trials,Section 4,2012),EMBSE (from Jan,1974 to Dec,2012),CNKI (from Mar,1994 to Feb,2012),the American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO)databases,the open published randomized controlled trials of about the relationship between prophylactic use of octreotide and postoperative pancreatic fistula risk in patients treated with pancreatic surgery were collected.The pooled risk ratio (RR)of postoperative pancreatic fistula between the two groups was calculated by suing statistic software Stata1 1.0.Result:Fifteen RCTs were include in this meta-analysis.1089 patients were in the prophylactic octreotide group with 141 cases of postoperative pancreatic fistula,and 1035 subjects were in the control group with 241 cases of postoperative pancreatic fistula.Meta-analysis demonstrated that patients in prophylactic octreotide group had less postoperative pancreatic fistula risk compared to control group (RR=0.63,95％CI:0.47 ～ 0.86,P=0.003).Conelusion:Prophylactic use of octreotide can significant reduce the risk of postoperative pancreatic fistula in patients treated with pancreatic surgery.