Abstract: 【Abstract】〓Objective〓To investigate the relation between the risk factor of postoperative complications in patients with inflammatory bowel disease (IBD) and preoperative steroids usage, Methods〓We searched medical electronic database for full articles published since the year 1970 concerning postoperative complications in patients with IBD who undergone abdominal surgery. The perioperative patients with steroid or not were analyzed. Randomized effect or fixed effect was carried out depending on heterogenicity of the studies. Results〓A total of 28 retrospective studies met the inclusion criteria.Pooled analysis demonstrated an increased risk of total postoperative complications (OR=1.42, 95% CI: 1.61-1.75, P=0.0007) and infectious complications (OR=2.28, 95% CI: 1.49-3.49, P=0.0002) among patients using steroid preoperatively. Patients receiving higher dose of steroids (>20 mg/d) suffered from a higher risk of total complications (OR=1.45, 95% CI: 1.04-2.02, P=0.03) and infectious complications (OR=2.04, 95% CI: 1.05-3.95, P=0.04), compared with the lower group. Conclusion〓Total complications and infectious complications increased in IBD patients following preoperative steroid use after abdominal surgery. Preoperative dose of steroids under 20 mg/d could reduce this risk.

Key words: Steroid, Inflammatory bowel disease, Complication, Meta-analysis

摘要： 【摘要】 目的 评价术前糖皮质激素的使用与否及不同剂量对炎症性肠病术后并发症的影响。方法 检索医学数据库中1970年后所有对比炎症性肠病患者术前应用糖皮质激素与否对术后并发症影响的文献。将符合文献质量评价标准的文献纳入后,根据研究的异质性分别采用固定效应模型或随机效应模型进行荟萃分析。结果 共有28项回顾性研究纳入分析。研究结果显示术前应用糖皮质激素明显增加术后总体并发症(OR=1.42, 95% CI: 1.61-1.75,P=0.0007)及感染性并发症(OR=2.28, 95% CI: 1.49-3.49, P=0.0002)的发病率。而术前接受高剂量(>20 mg/d)糖皮质激素治疗的患者,术后总体并发症(OR=1.45, 95% CI: 1.04-2.02, P=0.03)及感染性并发症(OR=2.04, 95% CI: 1.05-3.95, P=0.04)的发病率均显著高于术前接受低剂量(<20 mg/d)糖皮质激素治疗的患者。结论〓术前糖皮质激素的使用增加炎症性肠病的术后总体并发症和感染性并发症的发病风险,术前将糖皮质激素降至20 mg/d以下将降低这个风险。

关键词: 糖皮质激素, 炎症性肠病, 并发症, 荟萃分析