腹腔镜与开腹修补消化性溃疡穿孔的比较的Meta分析

发布时间：2018-11-25 12:47

【摘要】：目的:系统评价腹腔镜与开腹消化性溃疡穿孔修补术的安全性以及有效性。方法:收集1980年1月-2014年9月的已经发表的有关腹腔镜与开腹修补消化性溃疡穿孔的疗效的比较的中文和英文文献,中文文献(万方数据知识服务平台、中国知网),英文文献(ochrane Library,Pub Med,Embase)。英文检索腹腔镜AND(开腹OR开放)AND溃疡穿孔修补。根据文献的纳入排除标准,由两名研究生分别单独对符合条件的文献进行相关资料的输出,如果有不同的意见进行讨论解决。使用Rev Man 5.2.7版本软件对输出的资料进行meta分析;利用Rev Man 5.2.7软件完成异质性分析检验,根据异质性的结果选择固定或者随机效应模型。发表偏倚用漏斗图来表示。结果:符合本研究条件的共有6篇随机对照试验,共计682例患者,其中腹腔镜组有362例,开腹组有320例。Meta分析结果显示,腹腔镜与开腹消化性溃疡穿孔修补术比较,腹腔镜手术组术中出血量较少(P0.00001);肠蠕动恢复时间较短(P=0.002);住院时间缩短(P0.00001);术后主要并发症如切口感染(P0.00001)、肺部感染(P=0.04)、术后肠梗阻(P=0.03)发生率减少,而在手术时间(P=0.37)、腹腔脓肿(P=0.57)、术后死亡率(P=0.34)方面,腹腔镜组与开腹组之间的差异并无统计学意义。结论:腹腔镜手术治疗消化性溃疡穿孔与开腹手术相比,出血较少、打击小、术后恢复更加迅速、术后主要并发症发生率也较低,是一种安全可行的治疗手段。
[Abstract]:Objective: to evaluate the safety and efficacy of laparoscopic and open peptic ulcer perforation repair. Methods: from January 1980 to September 2014, Chinese and English literatures on the efficacy of laparoscopic and open repair of peptic ulcer perforation were collected. English literature (ochrane Library,Pub Med,Embase). To search laparoscopic AND (open OR open) AND ulcer perforation repair. According to the inclusion and exclusion criteria of the literature, two graduate students separately carry on the relevant data output to the qualified documents, if there are different opinions to discuss and solve. The outputted data are analyzed by meta using Rev Man version 5.2.7 software, and the heterogeneity analysis test is completed by Rev Man 5.2.7 software. According to the results of heterogeneity, fixed or random effect models are selected. Publication bias is represented by funnel diagrams. Results: a total of 6 randomized controlled trials were conducted, including 362 cases in the laparoscopic group and 320 cases in the open group. Meta analysis showed that laparoscopic repair of peptic ulcer perforation was compared with laparoscopy. The amount of intraoperative bleeding was less in the laparoscopic operation group (P0.00001). The recovery time of intestinal peristalsis was shorter (P0. 002), the hospitalization time was shorter (P0. 00001). The main postoperative complications such as incision infection (P0.00001), pulmonary infection (P0. 04), postoperative intestinal obstruction (P0. 03) were decreased, but at the time of operation (P0. 37), abdominal abscess (P0. 57). There was no significant difference in postoperative mortality (P < 0. 34) between laparoscopy group and open group. Conclusion: laparoscopic surgery for peptic ulcer perforation is a safe and feasible method for the treatment of peptic ulcer perforation with less bleeding, less attack, faster postoperative recovery and lower incidence of major postoperative complications.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.62

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