胰胃吻合和胰空肠吻合在胰十二指肠切除术后并发症的Meta分析
发布时间：2018-07-27 09:50
【摘要】：目的:评价胰十二指肠切除术后胰胃吻合术与胰空肠吻合术的疗效。方法:通过计算机检索1994年1月1日至2014年8月31日在Cochrane、PubMed、Medline、EMBASE、Science Direct、Springerlink、CBM数据库、中国知网、万方以及维普数据库公开发表的文献及相关文章的参考文献。按照纳入及排除标准,经筛选后纳入的Meta分析的RCT文献共13篇,对所纳入的文献进行质量评估并提取数据。以术后胰漏、腹腔感染、胆漏、胃排空障碍,术后出血、并发症,总死亡率为观察指标。应用RevMan5.2软件进行统计学分析。采用x2检验分析统计学异质性,若P≥0.10,则采用固定效应模型进行Meta分析,若P0.10,则采用随机效应模型进行Meta分析。按照各文献数据提取结果对各个结局指标进行统计分析并绘制森林图,计数资料选取比数比(OR)及其95%可信区间(95%CI)表示,计量资料以均数差(MD)及其95%可信区间(95%CI)表示,发表偏倚用漏斗图评估,P0.05认为有统计学意义。结果:按照检索策略和资料收集方法,共检索到文献1684篇,筛选后最终纳入13篇RCT文献,其中英文10篇,中文硕士学位论文3篇,13篇文献质量评价优良。13个研究纳入病例1870例,其中PG组904例,PJ组966例。Meta分析结果显示:PG和PJ相比,PG组能降低术后胰漏发病率,合并OR值:0.54,95%CI:0.44-0.70,P0.00001。PG组能降低术后腹腔感染的发病率,合并OR值:0.46,95%CI:0.32-0.660,P0.0001,PG组胆漏发病率也有所降低,合并OR值:0.47,95%CI:0.27-0.82,P0.008。术后胃排空障碍合并OR值:1.22,95%CI:0.88-1.70,P0.23;术后出血合并OR:1.11,95%CI:0.77-1.59,P=0.58,术后并发症合并OR:0.96,95%CI:0.76-1.20,P0.70,术后死亡率合并OR值:0.77,95%CI:0.44-1.32,P0.34。结论:PG在术后胰漏、胆漏、腹腔感染的发病率方面优于PJ,在胃排空障碍、术后出血、术后总并发症发病率、死亡率方面的差异无统计学意义,但此结果仍需多中心、大样本、前瞻性RCT研究验证。
[Abstract]:Objective: to evaluate the effect of pancreaticogastrostomy and pancreaticojejunostomy after pancreaticoduodenectomy. Methods: from January 1, 1994 to August 31, 2014, we searched the CBM database published in Cochraneberg Medline, EMBASE Science Direct link CBM, China Zhiwang, Wanfang and Weip databases, and the references of related articles. According to the inclusion and exclusion criteria, 13 RCT articles were selected and analyzed by Meta. The quality of the literature was evaluated and the data were extracted. Postoperative pancreatic leakage, intraperitoneal infection, bile leakage, gastric emptying disorder, postoperative bleeding, complications and total mortality were taken as indexes. RevMan5.2 software was used for statistical analysis. The statistical heterogeneity was analyzed by x2 test. If P 鈮，
本文编号：2147447
[Abstract]:Objective: to evaluate the effect of pancreaticogastrostomy and pancreaticojejunostomy after pancreaticoduodenectomy. Methods: from January 1, 1994 to August 31, 2014, we searched the CBM database published in Cochraneberg Medline, EMBASE Science Direct link CBM, China Zhiwang, Wanfang and Weip databases, and the references of related articles. According to the inclusion and exclusion criteria, 13 RCT articles were selected and analyzed by Meta. The quality of the literature was evaluated and the data were extracted. Postoperative pancreatic leakage, intraperitoneal infection, bile leakage, gastric emptying disorder, postoperative bleeding, complications and total mortality were taken as indexes. RevMan5.2 software was used for statistical analysis. The statistical heterogeneity was analyzed by x2 test. If P 鈮，
本文编号：2147447
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