| Background: At present,the treatment of early fluid resuscitation for acute pancreatitis is controversial.In this paper,the existing evidences were analyzed.Objective:To evaluate whether early aggressive fluid resuscitation is helpful to improve the prognosis of patients with acute pancreatitis,and to provide references for clinical treatment.Methods:PubMed,Cochrane Library,EMBASE and CNKI were searched by computer.The time limit of searching was from the establishment of each database to December 2019.RCTs of early aggressive fluid resuscitation in the treatment of acute pancreatitis were searched.The data of clinical research that met the standards were extracted and the risk of bias was evaluated.Revman 5.3 statistical software was used for meta analysis of clinical indicators.Results: A total of 639 patients were included in 9 RCTs.The results of meta-analysis showed that: Compared with the non-aggressive fluid resuscitation,the aggressive fluid resuscitation may be more unfavorable to the prognosis of patients,the difference was statistically significant: the improvement of gastrointestinal function [RR = 0.84,95% CI(0.74,0.97),P = 0.01],the incidence of abdominal compartment syndrome [RR = 4.37,95% CI(1.57,12.20),P = 0.005],the incidence of MODS [RR = 6.4,95%CI(2.63,15.6),P< 0.0001],the incidence of SIRS [RR = 1.3,95% CI(1.04,1.64),P = 0.02],the incidence of mechanical ventilation [RR = 2,95% CI(1.02,3.94),P = 0.04],mortality [RR = 2.66,95% CI(1.59,4.46),P =0.0002].Conclusion: Early aggressive fluid resuscitation may be harmful to the prognosis of patients with acute pancreatitis,but because of the large differences in the population and the severity of acute pancreatitis in the studies,more randomized controlled trials are needed to confirm which type of fluid resuscitation is beneficial to patients or which type of patients is beneficial to the aggressive fluid resuscitation. |
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