倒刺缝线在妇科腔镜手术中应用的Meta分析

发布时间：2018-01-30 23:59

本文关键词： 倒刺缝线妇科手术 Meta分析　出处：《中国内镜杂志》2015年09期 　论文类型：期刊论文

【摘要】：目的系统评价倒刺缝线在妇科腔镜手术中应用的疗效和安全性。方法计算机检索Cochrane图书馆、Pub Med、EMBASE、CBM、CNKI、VIP和万方,均截至2014年9月。全面收集倒刺缝线在妇科腔镜手术中应用的临床试验,采用Cochrane系统评价的方法,提取数据,评价研究质量,并采用Rev Man 5.2软件进行合并分析。结果共纳入5项研究,包括237例患者。Meta分析结果显示,倒刺缝合子宫肌壁时间明显减少了子宫肌壁缝合时间[MD=-5.90,95%CI(-7.70,-4.10)]和术中出血量[MD=-0.47,95%CI(-0.85,-0.08)],降低手术难度[MD=-2.24,95%CI(-3.02,-1.47)]。而在阴道残端时间[MD=-2.95,95%CI(-6.93,1.03)]和总的手术时间[MD=-4.26,95%CI(-10.11,1.58)],两组间差异无统计学意义。在安全性方面,倒刺缝线和普通缝线相比未增加任何不良反应的风险。结论倒刺缝线可以明显减少子宫肌壁缝合时间,减少术中失血量以及妇科腹腔镜手术的难度,同时未增加并发症的风险。而对于其是否可以减少阴道残端的缝合时间,仍需要大样本随机对照试验进一步研究。
[Abstract]:Objective to evaluate the efficacy and safety of inverted suture in gynecological endoscopic surgery. Methods Cochrane library was searched by computer. As of September 2014, the clinical trials of inverted suture in gynecological endoscopic surgery were collected, and the data were extracted by Cochrane system evaluation method. The quality of the study was evaluated and combined analysis was carried out with Rev Man 5.2 software. The results were included in 5 studies, including 237 patients. Meta-analysis results showed. The suture time of uterine muscle wall was significantly reduced by inverted suture of uterine muscle wall. [MD-5.90 ~ 95 CIQ -7.70 ~ 4.10)] and intraoperative bleeding volume. [MD-0.47 ~ 95CIQ (-0.85U -0.08)], to reduce the difficulty of operation. [The time of vaginal stump was 3.02U -1.47). [MD-2.95 / 95 CIQ (-6.93 / 1.03)] and total operation time. [There was no significant difference between the two groups in terms of safety. Conclusion Splice suture can significantly reduce the time of uterine muscle wall suture, reduce the amount of blood loss during operation and the difficulty of gynecological laparoscopic surgery. There is also no increased risk of complications, and whether it can reduce the suture time of the vaginal stump requires further study in a large sample of randomized controlled trials.
【作者单位】：福建医科大学教学医院(福建省妇幼保健院)妇科;
【分类号】：R713
【正文快照】： 随着微创技术的发展,腹腔镜已经成为治疗妇科疾病的重要手术方式,其创伤小、康复快,临床应用价值得到广泛认可。但是在子宫肌瘤剔除术和子宫切除术中,即使是熟练的妇科腔镜医师,在缝合子宫切口和阴道残端时仍然需要耗费较多的时间,而且缝合的张力也很难把握,术中出血量增多,血

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