择期肝脏切除术后常规安置腹腔引流管与未安置引流管比较的Meta分析

发布时间：2018-05-08 18:41

本文选题：择期肝脏切除术 + 腹腔引流管　；参考：《现代预防医学》2017年11期

【摘要】：目的系统评价择期肝脏切除术后的病人常规安置腹腔引流管(RAD)与未安置引流管(NRAD)的差别,为临床医师合理选择处理方法提供循证医学证据。方法检索国内外各大数据库及各类会议论文,查找采用随机或半随机方法比较肝脏切除术后是否安置腹腔引流管的研究,并对所有的纳入研究进行分析以及质量评价,采用Cochrane library提供的软件进行分析。结果研究最后纳入文献9篇,共包括1 418例患者,其中RAD组851例,NRAD组567例。结果表明:与RAD组相比,NRAD组感染性腹腔积液的发生率更低[RR=2.38,95%CI(1.20,4.71),P=0.01]。其他临床观察指标如术后死亡、再手术、需要额外处理的腹腔积液、伤口感染、胆漏等的发生率在两组间比较差异无统计学意义。结论当经验丰富的外科医生对术中情况满意时,择期肝脏切除的患者并非需要常规预防性安置腹腔引流管,该结论仍需要更大样本的随机对照试验进行验证。
[Abstract]:Objective to systematically evaluate the difference between conventional placement of abdominal drainage tube (RAD) and non-implanted drainage tube (NRAD) in patients after elective hepatectomy, and to provide evidence for clinicians to choose reasonable treatment methods. Methods We searched all kinds of databases and conference papers at home and abroad to find out whether the abdominal drainage tube was placed after hepatectomy by random or semi-random method, and to analyze and evaluate the quality of all the included studies. The software provided by Cochrane library is used to analyze. Results at the end of the study, 9 articles were included, including 1 418 patients, including 851 cases in RAD group and 567 cases in NRAD group. The results showed that the incidence of infective peritoneal effusion in RAD group was lower than that in RAD group. There was no significant difference between the two groups in the incidence of other clinical indicators such as postoperative death reoperation abdominal effusion which needed extra treatment wound infection and bile leakage. Conclusion when an experienced surgeon is satisfied with the operation, the patients undergoing selective hepatectomy do not require routine preventive placement of the peritoneal drainage tube. This conclusion still needs to be verified by a larger sample of randomized controlled trials.
【作者单位】：西南医科大学附属医院肝胆外科;
【分类号】：R657.3

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