早期不同时间点行腹腔镜胆囊切除术治疗急性结石性胆囊炎疗效及安全性的Meta分析

发布时间：2018-07-07 20:32

本文选题：胆囊炎 + 急性　；参考：《中国普通外科杂志》2017年08期

【摘要】：目的:比较早期不同时间点行腹腔镜胆囊切除术(LC)治疗急性结石性胆囊炎(ACC)的疗效及安全性。方法:检索2017年4月以前国内外数据库公开发表的比较不同时机LC治疗ACC疗效及安全性的临床研究。采用RevMan 5.3软件对相关临床指标进行Meta分析。结果:共纳入15篇文献,共16 389例患者,其中13 417例发病48 h内行LC,2 972例发病48~72 h内行LC。Meta分析结果显示,48 h内行LC者较48~72 h内行LC者手术时间缩短(MD=-11.33,95%CI=-17.26~-5.40,P=0.0002)、术中出血量减少(MD=-24.60,95%CI=-45.83~-3.36,P=0.02)、胆管损伤发生率降低(OR=0.48,95%CI=0.26~0.90,P=0.02)、中转开腹率降低(OR=0.56,95%CI=0.43~0.74,P0.0001);而两组患者的住院时间、总并发症发生率、胆汁漏发生率、肠梗阻发生率、术后腹腔内出血发生率、切口感染发生率、腹腔感染发生率、肺部感染发生率以及切口疝发生率的差异均无统计学意义(均P0.05)。结论:ACC患者在发病48 h内行LC具有较好的疗效及安全性。
[Abstract]:Objective: to compare the efficacy and safety of early laparoscopic cholecystectomy (LC) in the treatment of acute calculous cholecystitis (ACC). Methods: the efficacy and safety of LC in the treatment of ACC before April 2017 were searched. The related clinical indexes were analyzed by Revman 5.3 software. Results: a total of 16 389 patients were included in 15 articles. The results of LC.Meta-analysis showed that the operation time of LC within 48 h was shorter than that of LC within 48 h (MD-11.33 / 95 CI-17.26 ~ -5.40 P0.0002), the blood loss during operation was decreased (MD-24.6095CI-45.83 ~ 3.36 P0. 02), the incidence of bile duct injury was decreased (OR.0.495 CI0.260.90 P0. 02). The number of patients in the two groups was 0.430.74, P 0.0001, and the length of stay in the two groups was lower than that in the control group. There was no significant difference in the incidence of total complications, bile leakage, intestinal obstruction, postoperative intraperitoneal hemorrhage, incision infection, abdominal cavity infection, pulmonary infection and incisional hernia (P0.05). Conclusion LC is effective and safe in patients with ACC within 48 hours after onset.
【作者单位】：江苏大学附属医院普通外科;
【基金】：江苏省“六大人才高峰”高层次人才资助项目(2016-WSN-007)
【分类号】：R657.4

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