阑尾切除术与抗生素比较治疗急性单纯性阑尾炎疗效和安全性的Meta分析

发布时间：2018-06-28 03:02

本文选题：急性阑尾炎 + 抗生素　；参考：《中国循证医学杂志》2017年02期

【摘要】：目的系统评价阑尾切除术与抗生素比较治疗急性单纯性阑尾炎的疗效和安全性。方法计算机检索Pub Med、EMbase、The Cochrane Library(2016年8期)、Web of Science、CBM、Wan Fang Data和CNKI数据库,搜集关于阑尾切除术与抗生素比较治疗急性单纯性阑尾炎的随机对照试验(RCT),检索时限均从建库至2016年9月。由两位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果最终纳入10个RCT,包括2 028例患者。Meta分析结果显示:与抗生素治疗单纯性急性阑尾炎相比,阑尾切除术能缩短住院时间[MD= 1.89,95%CI( 2.75, 1.04),P0.000 01]、抗生素使用时间[MD= 4.42,95%CI( 5.06, 3.79),P0.000 01],提高有效率[OR=23.48,95%CI(7.99,68.96),P0.000 01],降低复发率[OR=0.02,95%CI(0.01,0.05),P0.000 01];但在并发症发生率方面,两组差异无统计学意义[OR=1.35,95%CI(0.31,5.87),P=0.69]。结论现有证据表明,与抗生素相比,阑尾切除术治疗单纯性阑尾炎能缩短住院时间、抗生素使用时间,提高有效率,降低复发率,但两种治疗方式在治疗并发症发生率方面无显著差异。受纳入研究质量的限制,上述结论尚需开展更多高质量的研究予以验证。
[Abstract]:Objective to evaluate the efficacy and safety of appendectomy and antibiotics in the treatment of acute simple appendicitis. Methods the databases of Pub MedEMbase, the Cochrane Library (issue 8, 2016) and the Web of Science (CBMN Wan Fang data and CNKI) were searched. The randomized controlled trial (RCT) of appendectomy compared with antibiotics for the treatment of acute simple appendicitis was collected. The retrieval time was from the establishment of the database to September 2016. After two evaluators independently sifted the literature, extracted the data and evaluated the bias risk of the study, the Meta-analysis was carried out by using Rev Man 5.3 software. Results Ten RCTs were included, including 2,028 patients. Meta-analysis showed that compared with antibiotic therapy for simple acute appendicitis, Appendectomy could shorten the hospitalization time [MD= 1.89 卤95CI (2.75, 1.04) P0.00001], but there was no significant difference in the incidence of complications between the two groups [MD= 4.429595 CI (5.06, 3.79) P0.00001], increased the effective rate [OR23.4895CI (7.999.68.96) P0.00001], decreased the relapse rate [OR0.029595 (CI 10.05) P0.00001], but there was no significant difference in the incidence of complications between the two groups [OR1.355.87 (0.315.87) P0.69]. Conclusion compared with antibiotics, appendectomy can shorten the hospital stay, use antibiotics, improve the effective rate and reduce the recurrence rate. However, there was no significant difference in the incidence of complications between the two treatments. These conclusions need to be verified by more and more high-quality studies, which are limited by the quality of the research.
【作者单位】：兰州大学第一临床医学院;兰州大学第一医院;
【基金】：甘肃省自然科学研究基金计划项目(编号:1208RJZA217)
【分类号】：R656.8

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