ALPPS与经皮门静脉栓塞的两步肝切除术的meta分析

发布时间：2019-01-27 10:14

【摘要】：目的:对比评价ALPPS和经皮门静脉栓塞活动两步肝切除术的有效性、安全性。方法:计算机检索数据库Pubmed、Embase、Corchrane library、CNKI有关ALPPS与经皮门静脉栓塞后两步肝切除术的临床对比研究。筛选文献,提取数据,二分类变量采用比值比(OR)为效应量进行Meta分析,连续性变量采用均数标准差(SMD)进行Meta分析,使用Revman5.3进行meta分析。结果:共纳入6篇临床对比研究文献,包含ALPPS组78人,PVE组316人。两步手术完成率为:ALPPS 100%;PVE 84.5%(OR:7.85,95%CI1.89-32.6,Z=2.83,P=0.005)。残肝体积增长率:ALPPS 59%;PVE46.5%(MD=19.45,95%CI,5.19-33.71,Z=2.67,p=0.008)。总体住院时间:ALPPS组10.7天,PVE组29.3天(Z=5.05,MD=-19.5,95%CI,-22.44—11.67,P0.000001)。并发症发生率:ALPPS组42.6%,PVE组39.6%(OR:1.15,95%CI 0.68-1.94,Z=0.53,P=0.6)。病死率:ALPPS组6%,PVE组4%(OR=2.0,95%CI,0.69-5.81,P=0.21)。结论:ALPPS对残肝体积增生有明显帮助,较PVE组其并发症、病死率的发生无明显统计学差异。
[Abstract]:Objective: to evaluate the efficacy and safety of ALPPS and two-step hepatectomy with percutaneous portal vein embolization. Methods: Pubmed,Embase,Corchrane library,CNKI database was searched by computer for clinical comparison of ALPPS and two-step hepatectomy after percutaneous portal vein embolization. The two classification variables were analyzed by Meta with the ratio (OR) as the effect quantity, the continuous variables with the mean standard deviation (SMD) for the Meta analysis, and the Revman5.3 with the meta analysis. Results: a total of 6 clinical comparative studies were included, including 78 patients in ALPPS group and 316 in PVE group. The complete rate of two-step operation was 84.5% (OR:7.85,95%CI1.89-32.6,Z=2.83,P=0.005). The growth rate of residual liver volume: ALPPS 59% PVE 46.5% (MD=19.45,95%CI,5.19-33.71,Z=2.67,p=0.008). The total hospitalization time was 10.7 days in ALPPS group and 29.3 days in PVE group. The incidence of complications was 42.6% in ALPPS group and 39.6% in PVE group (OR:1.15,95%CI 0.68-1.94). Mortality: 4% (OR=2.0,95%CI,0.69-5.81,P=0.21) in ALPPS group. Conclusion: ALPPS has significant effect on residual liver volume hyperplasia, and there is no significant difference in complication and mortality between PVE group and PVE group.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R657.3

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