A Meta-analysis Of Total Parenteral Nutrition And Early Enteral Nutrition In Patients With Severe Acute Pancreatitis

Objective:To study the effect of total parenteral nutrition (TPN) and early enteral nutrition (EEN) in patients with severe acute pancreatitis (SAP)by a meta-analysis.Methods:We searched three medical databases, including CNKI,VIP Information, WANFANG Data. The Cochrane Collaboration's Review Manager 5.0 software was used for statistical analysis.Results:Compared with TPN , EEN was associated with significantly lower mortality(OR = 0.36,95% CI:0.21～0.59,P < 0.0001), and lower incidence of multiple organ dysfunction syndrome(OR = 0.23,95% CI:0.15～0.35,P < 0.00001),acute respiratory distress syndrome(OR = 0.48,95% CI:0.28～0.83,P = 0.008),pseudocyst(OR = 0.44,95% CI:0.26～0.75,P = 0.002 ) ,superinfection ( OR = 0.22,95% CI:0.13～0.39 , P < 0.00001),gastrointestinal bleeding(OR = 0.34,95% CI:0.19～0.63,P =0.0005).Conclusion:Compared with TPN,.EEN can significantly reduce the mortality from SAP and the incidence of complications of SAP including multiple organ dysfunction syndrome, acute respiratory distress syndrome, pseudocyst , superinfection and gastrointestinal bleeding.