术前胆道引流对胰十二指肠切除术后并发症的meta分析

发布时间：2018-02-10 21:52

本文关键词： 胰十二指肠切除术术前胆道引流梗阻性黄疸并发症　出处：《南昌大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:评估术前胆道引流(preoperative biliary drainage,PBD)的疗效,对低位梗阻性黄疸患者行胰十二指肠切除术(Pancreaticoduodenectomy,PD)后并发症及预后的系统评价。方法:根据Cochrane系统评价的要求,从Pub Med、MEDLINE、Embase数据库、CNKI(中国期刊知网)、万方数据库等,检索2004年至今的中英文文献临床对照研究。用Rev Man5.2软件对胰十二指肠切除术后并发症及预后的荟萃分析。结果:最终符合入选标准的19篇文献,共有2235例梗阻性黄疸患者被纳入研究,其中术前胆道引流(preoperative biliary drainage,PBD)组有1018例患者包括内引流或外引流,非术前胆道引流(no preoperative biliary drainage,NPBD)组1217例患者。19项研究中有5项是只采用内引流方式,其余14项都采用内引流或外引流。分别对患者PD术后并发症(伤口感染、腹腔出血、腹腔感染、消化道出血、胃排空障碍、胆漏、胰漏和总并发症)和死亡率进行荟萃分析,经Meta分析显示:PD前行PBD与NPBD两组间伤口感染、腹腔出血、腹腔感染、消化道出血、胃排空障碍、胆漏、胰漏和总并发症等差异无统计学意义(P0.05),PBD组术后死亡率(OR=0.59,95%CI=0.37~0.94,P=0.03)PBD组死亡率低于NPBD组,有统计学意义(P0.05)。结论:PD术前行PBD不能显著降低术后并发症的发生率但可以使PD术后死亡率降低。
[Abstract]:Objective: to evaluate the effect of preoperative biliary drainage and preoperative biliary drainage, and to evaluate the complications and prognosis of patients with low obstructive jaundice after pancreaticoduodenectomy. Methods: according to the requirements of Cochrane system evaluation, From Pub MedMed MEDLINEN Embase database, CNKI (Chinese Journal knowledge Network, Wanfang Database, etc.), To retrieve the clinical comparative study of Chinese and English literature from 2004 to present. A meta-analysis of complications and prognosis after pancreaticoduodenectomy was performed with Rev Man5.2 software. A total of 2235 patients with obstructive jaundice were included in the study. 1018 patients in the preoperative biliary drainage preoperative biliary drainage group included internal or external drainage. In the non-preoperative preoperative biliary drainage group, 5 of 1217 patients were treated with internal drainage only, the remaining 14 patients were treated with internal drainage or external drainage. The complications (wound infection, intraperitoneal hemorrhage, abdominal cavity infection, abdominal cavity infection) after PD were observed. A meta-analysis of gastrointestinal bleeding, gastric emptying disorder, bile leakage, pancreatic leakage and total complications) and mortality were performed. Meta analysis showed that there were wound infection, abdominal hemorrhage, abdominal infection, gastrointestinal hemorrhage, gastric emptying disorder between PBD and NPBD groups. There was no significant difference in postoperative mortality between PBD group (P 0.05) and total complication (P 0.05). The mortality rate in PBD group was lower than that in NPBD group. Conclusion PBD before PBD can not significantly reduce the incidence of postoperative complications but can reduce the postoperative mortality.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

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