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吲哚美辛栓预防经内镜逆行胰胆管造影术后胰腺炎有效性的系统评价再评价
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| 篇名： | 吲哚美辛栓预防经内镜逆行胰胆管造影术后胰腺炎有效性的系统评价再评价 |
| TITLE： | Effectiveness of Indomethacin Suppositories in the Prevention of Post-endoscopic Retrograde Cholangiopancrea- tography Pancreatitis ：A Reevaluation of Systematic Review |
| 摘要： | 目的：对吲哚美辛预防经内镜逆行胰胆管造影术后胰腺炎（PEP）的有效性的系统评价进行再评价，为该药预防PEP提供可靠的循证参考。方法：计算机检索PubMed、CochraneLibrary、Embase、中国生物医学文献数据库、中国知网、万方数据库和维普网，收集吲哚美辛预防PEP的系统评价，检索时限均为建库起至2020年11月。应用AMSTAR2量表、PRISMA声明和GRADE方法对纳入研究的方法学质量、报告质量和证据质量进行评价，并对PEP的预防有效性进行描述性分析。结果：最终得到23篇系统评价，其中中文12篇、英文11篇。22篇系统评价显示，吲哚美辛相比于安慰剂能有效降低PEP的发生率；8篇系统评价显示，吲哚美辛相比于安慰剂显著降低了中重度PEP的发生率；5篇系统评价显示，吲哚美辛相比于安慰剂可以降低患者术后高淀粉酶血症的发生率；3篇系统评价显示，吲哚美辛对PEP发生的高风险人群也有较好的预防效果。纳入系统评价的PRISMA得分在15.0～25.0之间；纳入系统评价的AMSTAR2方法学质量评价偏低，报告完整的关键条目为4、9、11、13；对纳入系统评价进行的GRADE证据质量评价结果显示，证据质量集中在低水平。结论：吲哚美辛在预防PEP方面具有一定效果。但由于所纳入文献整体证据质量不高，该结论需高质量临床研究进一步证实。 |
| ABSTRACT： | OBJECTIVE：To overview the systematic review on the effectiveness of indomethacin in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP），and to provide reliable evidence-based reference for the prevention of PEP. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，CBM，CNKI，Wanfang database and VIP，systematic review on indomethacin in the prevention of PEP were collected during the inception to Nov. 2020. The methodological quality ，report quality and evidence quality of the included studies were evaluated by AMSTAR 2 scale，PRISMA statement and GRADE method. The effectiveness of PEP prevention was described. RESULTS ：Finally，23 systematic reviews were obtained ，including 12 in Chinese and 11 in English. Tweenty-two systematic reviews showed that compared with placebo ， indomethacin could effectively reduce the incidence of PEP. Eight systematic reviews showed that indomethacin significantly reduced the incidence of moderate and severe PEP compared with placebo. Five systematic reviews showed that indomethacin could reduce the incidence of postoperative hyperamylasemia compared with placebo. Three systematic reviews showed that indomethacin also had a good preventive effect on people with high risk of PEP. PRISMA score of included systematic reviews ranged from 15 to 25. The quality evaluation of AMSTAR 2 methodology included in systematic reviews was low ，and the key items of complete report were 4，9，11 and 13. The GRADE evidence quality evaluation of the included systematic reviews showed that the quality of the evidence was concentrated in the low level. CONCLUSIONS ：Indomethacin has a certain effect in the prevention of PEP ，but the overall evidence quality of the included literatures is generally not high. It needs to be further validated by high-quality clinical research. |
| 期刊： | 2021年第32卷第17期 |
| 作者： | 赵成思，姚维杰，彭波，杨亚飞，兰柱，董桐桐，史金平，王佐正 |
| AUTHORS： | ZHAO Chengsi，YAO Weijie，PENG Bo，YANG Yafei，LAN Zhu，DONG Tongtong，SHI Jinping，WANG Zuozheng |
| 关键字： | 经内镜逆行胰胆管造影术后胰腺炎；吲哚美辛；有效性；系统评价；再评价 |
| KEYWORDS： | Post-endoscopic retrograde cholangiopancreatography pancreatitis ；Indomethacin；Effectiveness； Systematic |
| 阅读数： | 206 次 |
| 本月下载数： | 6 次 |
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