小儿腹股沟疝腹腔镜术与开放性手术疗效和安全性的Meta分析

发布时间：2018-05-01 22:03

  本文选题：腹股沟疝 + 腹腔镜术　； 参考：《兰州大学》2012年硕士论文

【摘要】：目的比较腹腔镜术与开放性手术治疗小儿腹股沟疝的疗效和安全性。 方法计算机检索PubMed、EMBASE、Cochrane图书馆、中国生物医学文献数据库、中文科技期刊全文数据库、中国知识基础设施工程和万方数字化期刊,检索时间均从建库至2010年3月。纳入有关腹腔镜术与开放性手术治疗小儿腹股沟疝的RCT文献,根据Cochrane Handbook5.0.2质量评价标准评价纳入文献的质量。评价两种术式的手术持续时间、术后总并发症的发生率、腹股沟疝的复发率、术后恢复日常活动时间和术中出血量。采用RevMan5.0软件对数据进行定量合并。 结果最终纳入5篇RCT文献(共纳入586例患儿)。Meta分析结果显示：与开放性手术相比,腹腔镜术可以减少术中出血量[MD=-1.35,95%CI(-1.80,-0.90),P0.00001],但延长了单侧腹股沟疝的手术持续时间[MD=10.23,95%CI(4.33,16.14), P=0.0007],不增加腹股沟疝的复发率[RR=0.51,95%CI(0.15,1.73), P=0.28]和术后总并发症的发生率[RR=0.16,95%CI(0.02,1.49), P=0.11],不能缩短术后恢复日常活动时问[SMD=-0.19,95%CI(-0.49,0.11), P=0.21]。 结论现有临床证据显示：腹腔镜术与开放性手术相比,可减少术中出血量,不增加腹股沟疝的复发率和术后总并发症的发生率,但不能缩短术后恢复日常活动时间,延长了单侧腹股沟疝的手术持续时间。期待更多高质量、随访期长的相关随机对照试验进一步验证。
[Abstract]:Objective to compare the efficacy and safety of laparoscopic and open operation in the treatment of inguinal hernia in children. Methods A computer-based search was conducted for PubMedus EMBASE Cochrane Library, Chinese Biomedical Literature Database, full text Database of Chinese Science and Technology Journals, Chinese knowledge Infrastructure Engineering and Wanfang Digital Journals. The retrieval time was from the establishment of the database to March 2010. The RCT literature on laparoscopic and open operation for inguinal hernia in children was included, and the quality of the literature was evaluated according to Cochrane Handbook5.0.2 quality evaluation criteria. The duration of the two operations, the incidence of postoperative complications, the recurrence rate of inguinal hernia, the recovery time of daily activities and the amount of intraoperative bleeding were evaluated. RevMan5.0 software was used to combine the data quantitatively. Results five articles of RCT were included. The results of Meta-analysis showed that compared with open surgery, the results of meta-analysis showed that: 1. 鑵硅厰闀滄湳鍙�浠ュ噺灏戞湳涓�鍑鸿��閲廩MD=-1.35,95%CI(-1.80,-0.90),P0.00001],浣嗗欢闀夸簡鍗曚晶鑵硅偂娌熺枬鐨勬墜鏈�鎸佺画鏃堕棿[MD=10.23,95%CI(4.33,16.14), P=0.0007],涓嶅�炲姞鑵硅偂娌熺枬鐨勫�嶅彂鐜嘯RR=0.51,95%CI(0.15,1.73), P=0.28]鍜屾湳鍚庢，

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