保留十二指肠的胰头切除术与胰十二指肠切除术治疗慢性胰腺炎的Meta分析
发布时间：2018-12-11 05:04
【摘要】：目的:通过Meta分析,对胰十二指肠切除术(保留或不保留幽门,pylorus-preserving pancreatoduodenectomy,PPPD/pancreatoduodenectomy,PD)与保留十二指肠的胰头切除术(duodenum-preserving pancreatic head resection,DPPHR)治疗慢性胰腺炎的安全性和有效性进行评价。方法:在Pubmed、EMbase、Springer-Link、The Cochrane Library上系统检索关于PPPD/PD与DPPHR治疗慢性胰腺炎的随机对照试验(randomized controlled trial,RCT),根据Cochrane Handbook 5.1对纳入的文献进行偏倚风险评估。统计学软件选用Rev Man 5.3,对两种术式的围术期死亡率、术后疼痛缓解、术后胰腺内、外分泌功能障碍和整体生活质量等方面的数据进行处理和分析。结果:共有7个随机对照试验,366例患者被纳入分析。PPPD/PD组与DPPHR组比较,在术后疼痛缓解(RR=0.92,P=0.26)、围术期死亡率(RR=0.75,P=0.45)、术后新发胰腺内分泌功能障碍(RR=1.30,P=0.15)、术后新发胰腺外分泌功能障碍(RR=2.43,P=0.10)、术后总并发症发生情况(RR=1.70,P=0.13)等方面的差异无统计学意义;在术后恢复工作(RR=0.72,P=0.008)、整体生活质量(WMD=-12.06,P0.01)、体重增加(WMD=-4.16,P0.01)和手术时间(WMD=101.53,P0.01)方面的差异有统计学意义,显示DPPHR组要优于PPPD/PD组。结论:DPPHR与PPPD/PD在围术期死亡率、术后疼痛缓解、术后新发胰腺内、外分泌功能障碍、术后总并发症方面同样安全和有效,但DPPHR在手术时间、术后体重增加情况、术后工作恢复情况等方面较PPPD/PD有优势,能明显改善患者术后的整体生活质量。
[Abstract]:Objective: to analyze the relationship between pancreaticoduodenectomy (pylorus-preserving pancreatoduodenectomy,PPPD/pancreatoduodenectomy,PD) and duodenal preserving pancreatectomy (duodenum-preserving pancreatic head resection,) by Meta analysis. To evaluate the safety and efficacy of DPPHR in the treatment of chronic pancreatitis. Methods: a randomized controlled trial (randomized controlled trial,RCT) of PPPD/PD and DPPHR in the treatment of chronic pancreatitis was systematically searched on Pubmed,EMbase,Springer-Link,The Cochrane Library. The risk of bias was evaluated according to Cochrane Handbook 5.1. The data of perioperative mortality, postoperative pain relief, pancreatic dysfunction, exocrine dysfunction and overall quality of life were analyzed with Rev Man 5.3. Results: there were 7 randomized controlled trials in which 366 patients were included in the analysis. Pain relief (RR=0.92,P=0.26), perioperative mortality (RR=0.75,P=0.45), postoperative pain relief (RR=0.92,P=0.26) and perioperative mortality (RR=0.75,P=0.45) in the PPPD/PD group were compared with those in the DPPHR group. Postoperative pancreatic endocrine dysfunction (RR=1.30,P=0.15), postoperative pancreatic exocrine dysfunction (RR=2.43,P=0.10), total postoperative complications (RR=1.70,) There was no significant difference in P0. 13). There were significant differences in postoperative work recovery (RR=0.72,P=0.008), overall quality of life (WMD=-12.06,P0.01), weight gain (WMD=-4.16,P0.01) and operative time (WMD=101.53,P0.01). The DPPHR group is better than the PPPD/PD group. Conclusion: DPPHR and PPPD/PD are equally safe and effective in perioperative mortality, postoperative pain relief, postoperative pancreatic dysfunction, and total postoperative complications. However, DPPHR is safe and effective in the time of operation and weight gain after operation. The recovery of work after operation is superior to that of PPPD/PD, which can improve the overall quality of life of the patients.
【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】：R657.51
本文编号：2371925
[Abstract]:Objective: to analyze the relationship between pancreaticoduodenectomy (pylorus-preserving pancreatoduodenectomy,PPPD/pancreatoduodenectomy,PD) and duodenal preserving pancreatectomy (duodenum-preserving pancreatic head resection,) by Meta analysis. To evaluate the safety and efficacy of DPPHR in the treatment of chronic pancreatitis. Methods: a randomized controlled trial (randomized controlled trial,RCT) of PPPD/PD and DPPHR in the treatment of chronic pancreatitis was systematically searched on Pubmed,EMbase,Springer-Link,The Cochrane Library. The risk of bias was evaluated according to Cochrane Handbook 5.1. The data of perioperative mortality, postoperative pain relief, pancreatic dysfunction, exocrine dysfunction and overall quality of life were analyzed with Rev Man 5.3. Results: there were 7 randomized controlled trials in which 366 patients were included in the analysis. Pain relief (RR=0.92,P=0.26), perioperative mortality (RR=0.75,P=0.45), postoperative pain relief (RR=0.92,P=0.26) and perioperative mortality (RR=0.75,P=0.45) in the PPPD/PD group were compared with those in the DPPHR group. Postoperative pancreatic endocrine dysfunction (RR=1.30,P=0.15), postoperative pancreatic exocrine dysfunction (RR=2.43,P=0.10), total postoperative complications (RR=1.70,) There was no significant difference in P0. 13). There were significant differences in postoperative work recovery (RR=0.72,P=0.008), overall quality of life (WMD=-12.06,P0.01), weight gain (WMD=-4.16,P0.01) and operative time (WMD=101.53,P0.01). The DPPHR group is better than the PPPD/PD group. Conclusion: DPPHR and PPPD/PD are equally safe and effective in perioperative mortality, postoperative pain relief, postoperative pancreatic dysfunction, and total postoperative complications. However, DPPHR is safe and effective in the time of operation and weight gain after operation. The recovery of work after operation is superior to that of PPPD/PD, which can improve the overall quality of life of the patients.
【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】：R657.51
【参考文献】
相关期刊论文 前1条
1 苗毅;陈建敏;;胰头部肿块的病理学依据与手术决策[J];中国实用外科杂志;2009年08期
，本文编号：2371925
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