单孔与多孔腹腔镜脾脏切除术安全性及可行性比较的Meta分析

发布时间：2018-12-25 14:20

【摘要】：目的：系统评价单孔腹腔镜(SILS)与传统多孔腹腔镜脾切除术(LS)的临床安全性及可行性。方法：计算机检索PubMed、EMbase、MEDLINE、SCI、知网、万方数据库和The Cochrane Library,手工检索相关期刊及会议记录,同时追踪相关文章参考文献,收集单孔与多孔腹腔镜脾切除术的随机或非随机同期对照试验,检索时限截止至2014年10月。由两名评价者按照纳入与排除标准选择试验、提取所需资料和评价文献质量后,采用Cochrane平台推出的RevMan 5.2.5软件进行Meta分析。结果：本研究共纳入7个非随机对照试验(CCT),其中外文文献4篇,中文文献3篇,共202例患者。Meta分析显示手术时间(MD=-9.69；95%CI=-74.88, 55.51；P=0.77),术中出血量(MD=-27.82；95%=-101.23,45.59；P=0.46),平均住院天数(MD=-0.47；95%CI=-2.12,1.18；P=0.58),治疗费用(MD=-0.14；95%CI=-0.42,0.14；P=0.33),脾脏大小(MD=60.07；95%CI=-0.42,0.14；P=0.33)在两组间均无统计学差异,而术后疼痛(MD=-1.41；95%CI=-99.76,219.91；P=0.46),术后经肛门排气时间(MD=-0.47；95%CI=-0.84,0.10；P=0.01)均优于多孔腹腔镜脾切除术。结论：单孔腹腔镜脾切除术是安全、可行的。由于纳入研究数量和质量存在局限性,上述结论仍需大样本、高质量RCT进一步验证。
[Abstract]:Objective: to evaluate the clinical safety and feasibility of single-hole laparoscopic (SILS) and traditional porous laparoscopic splenectomy (LS). Methods: PubMed,EMbase,MEDLINE,SCI, Wanfang database and The Cochrane Library, were searched by computer for related journals and meeting records, and related articles were followed up. A randomized or non-randomized controlled trial of single hole and porous laparoscopic splenectomy was collected and the search time was up to October 2014. According to the criteria of inclusion and exclusion, the two evaluators selected the test, extracted the needed data and evaluated the quality of the literature, and then analyzed Meta with RevMan 5.2.5 software developed by Cochrane platform. Results: a total of 7 non-randomized controlled trial (CCT), were included in this study, including 4 foreign literature and 3 Chinese literatures. The Meta analysis showed the operative time (MD=-9.69;95%CI=-74.88, 55.51). P0. 77), intraoperative bleeding (MD=-27.82;95%=-101.23,45.59;P=0.46), average length of stay (MD=-0.47;95%CI=-2.12,1.18;P=0.58), treatment cost (MD=-0.14;) There was no significant difference in spleen size (MD=60.07;95%CI=-0.42,0.14;P=0.33) between the two groups, but there was postoperative pain (MD=-1.41;95%CI=-99.76219.91;). The postoperative transanal exhaust time (MD=-0.47;95%CI=-0.84,0.10;P=0.01) was better than that of porous laparoscopic splenectomy. Conclusion: single-hole laparoscopic splenectomy is safe and feasible. Due to the limitation of the quantity and quality of the study, these conclusions still need a large sample, which is further verified by high quality RCT.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.6

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