内科胸腔镜辅助治疗结核性胸腔积液的Meta分析

发布时间：2018-07-14 12:49

【摘要】：目的系统评价内科胸腔镜(Medical Thoracoscopy,MT)辅助治疗结核性胸腔积液(Tuberculous Pleural Effusion,TPE)的有效性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、WanFang Data、CBM和VIP数据库,检索关于MT辅助治疗TPE的相关研究文献,检索时限均从建库至2016年12月10日。由2位评价员按照纳入与排除标准独立筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan5.3软件进行Meta分析。结果共纳入21个研究,1858例患者。Meta分析结果显示:与N-MT相比,MT辅助治疗TPE在有效率[OR=15.13,95%CI(8.11,28.23),P0.00001],胸水总引流量[MD=465.30,95%CI(273.07,657.54),P0.00001],胸水消退时间[MD=-7.83,95%CI(-11.56,-4.11),P0.0001],住院时间[MD=-4.42,95%CI(-7.39,-1.44),P=0.004],肺功能FEV1%改善率[MD=4.79,95%CI(2.46,7.11),P0.0001]及肺功能FVC%改善率[MD=6.68,95%CI(4.61,8.76),P0.00001],胸膜厚度[MD=-0.76,95%CI(-0.99,-0.52),P0.00001]、胸膜增厚发生率[OR=0.27,95%CI(0.14,0.55),P=0.0003]及转手术率[OR=0.24,95%CI(0.15,0.41),P0.00001],临床症状消失时间[MD=-5.31,95%CI(-9.09,-1.53),P=0.006],拔管时间[MD=-6.24,95%CI(-6.61,-5.86),P0.00001],包裹性胸腔积液复发率[OR=0.37,95%CI(0.19,0.72),P=0.003]等方面,差异有统计学意义;但在不良反应发生方面,MT辅助治疗包裹性TPE[OR=0.80,95%CI(0.31,2.03),P=0.63]方面,差异无统计学意义。结论现有证据表明,MT辅助治疗TPE效果良好且并发症少,值得临床应用开展。鉴于纳入研究数量有限,上述结论尚需开展更多研究予以验证。
[Abstract]:Objective to evaluate the efficacy of medical Thoracos copyMT in the treatment of tuberculous pleural effusion (TPE). Methods the CBM and VIP databases of the Cochrane Library Web of Science and Technology were searched by computer, and the relevant literatures on MT adjuvant treatment of TPE were searched. The retrieval time was from the establishment of the library to December 10, 2016. After two evaluators independently sifted the literature according to the inclusion and exclusion criteria, extracted the data and evaluated the methodological quality of the study, the meta-analysis was carried out with Revman 5.3 software. 缁撴灉鍏辩撼鍏，

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