ALPPS一期手术中完全断肝法安全性的meta分析

发布时间：2018-08-07 09:24

【摘要】：目的:评价ALPPS一期手术中完全断肝法与非完全断肝法之间的安全性。方法:计算机检索Pubmed、Google Scholar、CNKI、万方等数据库,收集所有2017年2月以前关于对比ALPPS一期手术中完全断肝法和非完全断肝法比较的临床对比研究,进行文献筛选和资料提取,对文献数据使用RevMan5.3进行分析。结果:共纳入5篇临床对比研究,包含完全离断组86例,非完全断肝组74例,meta分析结果:完全断肝组在FLR增长率(P=0.16)、二步手术时间间隔(P=0.34)、术后院内死亡率(P=0.24)上的差异无统计学意义,但术后严重并发症(Grade≥3b)发生率高于非完全断肝组,比值比2.99,95%CI(1.04,8.58),P=0.04。结论:完全断肝法虽然在术后并发症发生率上高于非完全断肝组,但在院内死亡率上无明显差异,其安全性仍需更多大样本、多中心随机对照试验进一步证实。
[Abstract]:Objective: To evaluate the safety of complete liver disconnection and incomplete liver disconnection during the first phase of ALPPS operation. Methods: a computer retrieval of Pubmed, Google Scholar, CNKI, Wan Fang and other databases were used to collect all clinical comparative studies on the comparison of complete and non complete liver disconnection in the first phase of ALPPS operation before February 2017, and the literature screening was carried out. And data extraction, the literature data using RevMan5.3 analysis. Results: a total of 5 clinical comparative studies, including 86 cases of complete disconnection group, 74 cases of complete disconnection group, 74 cases of incomplete liver disconnection, meta analysis results: complete liver fault group in FLR growth rate (P=0.16), two step operation time interval (P= 0.34), postoperative hospital mortality (P=0.24) difference is not statistically significant. However, the incidence of postoperative severe complications (Grade > 3b) was higher than that in the non complete liver failure group, and the ratio ratio was 2.99,95%CI (1.04,8.58). Conclusion: Although the rate of postoperative complications was higher than that of the non complete liver failure group, there was no significant difference in the mortality rate in the hospital, and the safety of the complete liver failure still needed more large samples and a multi center randomized controlled trial. Step by step.
【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】：R657.3

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