单孔胸腔镜对比三孔胸腔镜手术治疗原发性自发性气胸的Meta分析

发布时间：2018-03-17 22:20

本文选题：电视辅助胸腔镜手术　切入点：原发性自发性气胸　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的进一步评价单孔电视辅助胸腔镜(VATS)与三孔VATS治疗原发性自发性气胸(PSP)的疗效。方法计算机检索Pub Med、Cochrane Library、Embase、Science Direct、Web of Science,中国知网及万方等数据库中关于单孔VATS与三孔VATS治疗PSP疗效对比的随机对照试验和非随机对照试验,检索时间为建库至2015年9月。由两位作者按照纳入与排除标准筛选文献、评价文献质量、提取资料和评价纳入研究的偏倚风险。然后使用Rev Man5.20软件进行Meta分析。结果共纳入6篇队列研究,共310个患者。Meta分析研究结果表明:与三孔VATS治疗PSP的疗效相比,单孔VATS的平均住院时间更短[MD=-0.39,95%CI(-0.69,-0.09),P=0.01],术后24 h疼痛VAS评分更低[MD=-0.78,95%CI(-1.40,-0.52),P0.00001],胸腔引流时间更短[MD=-0.68,95%CI(-1.15,-0.22),P=0.004],术后皮肤感觉异常发生率更低[OR=0.13,95%CI(0.06,0.29),P0.00001]。然而,与三孔VATS相比,单孔VATS在术后24 h[MD=-0.65,95%CI(-0.95,-0.35),P0.0001]和48 h[MD=-0.46,95%CI(-0.71,-0.21),P=0.0002]的病人满意度评分较低。两组在气胸复发率[OR=0.58,95%CI(0.20 to 1.67),P=0.32]、手术时间[MD=-1.01,95%CI(-4.63,2.60),P=0.58]和术后72 h[MD=-0.11,95%CI(-0.44,0.22),P=0.50]病人满意度评分方面,差异无统计学意义。结论单孔VATS与三孔VATS治疗PSP的疗效相比,单孔VATS的治疗效果更有优势。但仍然还需更大规模和更高质量的研究进行论证。
[Abstract]:Objective to further evaluate the efficacy of single hole video-assisted thoracoscopy (VATS) and three-hole VATS in the treatment of primary spontaneous pneumothorax (PSP). Methods to search the Pub Medchrane Library Embase Science Direct Science Web of Science of Science in the database of single hole VATS and three-hole VATS. A randomized controlled trial and a non-randomized controlled trial to compare the efficacy of PSP, The retrieval time was from the establishment of the database to September 2015. According to the criteria of inclusion and exclusion, the two authors screened the literature and evaluated the quality of the literature. Data were extracted and evaluated for bias risk in the study. Then Meta analysis was performed using Rev Man5.20 software. The results were included in 6 cohort studies. The results of a total of 310 patients. Meta-analysis showed that: compared with three-hole VATS treatment of PSP, the results showed that: 1. The average hospitalization time of single-hole VATS was shorter [MD-0.39-95CI-0.69C -0.09 P0.01], the VAS score of pain was lower 24 hours after operation [MD-0.7895 CIG-1.40 ~ -0.52C P0.00001], the time of thoracic drainage was shorter [MD-0.6895CI-1.15CI-0.22Pao 0.004], and the incidence of skin sensory abnormality was lower [OR0.1395CI0.060.29P0.00001]. However, compared with three-hole VATS, the incidence of abnormal skin sensation was lower [0.1395CI0.060.29P0.00001]. The satisfaction scores of patients with single-hole VATS were lower 24 hours after operation [MD-0.65CI-0.95 CI-0.95- 0.35C P0.0001] and 48h [MD-0.4695 CI-0.21CI-0.21CI-0.0002]. The two groups had lower satisfaction scores in the rate of pneumothorax recurrence [OR0.5895CI0.20 to 1.67CI0.32], the time of operation [MD-1.01CI-4.63CI-4.632.60P0.58] and the 72 h after operation [MD-0.1195CI-0.44440.220.22 / 0.50]. Conclusion compared with three-hole VATS, single-hole VATS is more effective than three-hole VATS in the treatment of PSP.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R655

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