Efficacy Of Probiotics Combined With Early Nutrition In Patients With Severe Acute Pancreatitis:A Meta-analysis

Objective:Meta-analysis of the efficacy and prognostic value of probiotics combined with early nutrition in patients with SAP provides evidence support for clinical treatment.Methods:Nine Chinese-foreign databases including VIP database,CNKI database,Wanfang database,CBM database,Pub Med,Ovid,Web of Science,Embase and Cochrane Library,were searched by computer.Meta-analysis of the included studies was performed using the software STATA 15 and Review Manager 5.3.Results:Fourteen articles were included,including 608 cases in the study group and 579 in the control group.Meta-analysis results were as follows: study group couldn’t reduce mortality and surgical treatment rate(P > 0.05).The other indicators were statistically significant(P<0.05).Incidence of MODS [RR = 0.66,95% CI(0.45,0.95)];Complication rate [RR =0.50,95% CI(0.29,0.85)];Infection rate [RR = 0.43,95% CI(0.31,0.60)];Hospital stay[MD =-4.69,95% CI(-7.41,-1.97)];Gastrointestinal function score [SMD =-2.36,95% CI(-3.48,-1.25)];laboratory indicators WBC [SMD =-0.61,95% CI(-0.82,-0.45)];AMY[SMD =-0.59,95% CI(-0.75,-0.43)];CRP [SMD =-1.28,95% CI(-1.48,-1.48)]-1.08)];TNF-α [MD =-22.26,95% CI(-26.00,-18.52)].Conclusion:Probiotic preparation combined with early nutritional therapy can restore gastrointestinal function and reduce systemic inflammatory response as soon as possible,significantly reduce the possibility of complications,MODS,infection and reduce the length of hospital stay in patients with SAP.However,it has no significant benefit on mortality and surgical treatment rates.Appropriate prolongation of the treatment time of probiotics is beneficial to the efficacy of SAP.