Prophylactic value of aggressive hydration with lactated Ringer′s solution during the perioperative period for post-ERCP pancreatitis:a meta-analysis
10.3760/cma.j.issn.1007-5232.2019.02.009
- VernacularTitle:围手术期利用乳酸林格氏液积极补液预防经内镜逆行胰胆管造影术术后胰腺炎的Meta分析
- Author:
Junsong YE
1
;
Lian WU
;
Daorong CHEN
Author Information
1. 重庆医科大学附属第一医院消化内科,重庆400016
- Keywords:
Pancreatitis;
Lactated Ringer′s solution;
Aggressive hydration;
Meta-analysis
- From:
Chinese Journal of Digestive Endoscopy
2019;36(2):124-130
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate aggressive hydration with lactated Ringer′s solution for prophylaxis of post-ERCP pancreatitis ( PEP ) during the perioperative period. Methods CNKI, VIP, Wangfang,Pubmed,Embase and Cochrane Library were searched for randomized controlled trials( RCTs) on aggressive hydration with lactated Ringer′s solution for preventing PEP published from the setup time of databases to June 2018. According to the inclusion and exclusion criteria, RCTs were selected by two researchers,data were extracted and methodological quality was assessed independently. Revman 5. 3 was used to perform the meta-analysis.The heterogeneity among the included RCTs was analyzed by using the Q test and the chi-square test. The funnel plots,the risk of bias graph and the risk of bias summary were used to evaluate publication bias. Results A total of 10 RCTs with 1727 patients were included. Meta-analysis showed that 10 RCTs had no significant heterogeneity ( P=0. 10, I2 =39％) , aggressive hydration with lactated Ringer′s solution could reduce the incidence of PEP(OR=0. 37,95％CI:0. 26-0. 53,P<0. 00001). Hyperamylasemia incidence was included in 6 RCTs,and the results showed that aggressive hydration with lactated Ringer′s solution could reduce the incidence of hyperamylasemia ( OR=0. 41, 95％CI:0. 27-0. 64, P<0. 00001 ) . A total of 4 RCTs compared the incidence of abdominal pain after ERCP between the experimental group and the control group. Meta-analysis showed that aggressive hydration with lactated Ringer′s solution could reduce the incidence of abdominal pain ( OR=0. 32, 95％CI: 0. 15-0. 68, P=0. 003) . Conclusion Aggressive hydration with lactated Ringer′s solution can effectively prevent PEP and other complications.
