导管对粘膜吻合法与套入式吻合法在胰十二指肠切除术中胰肠重建的对比meta-分析

发布时间：2021-10-18 14:44

　　目的:通过对胰十二指肠切除术中胰空肠吻合的导管对粘膜吻合法与套入式吻合法的术后胰漏发生率、并发症发生率、病死率等相关指标进行Meta分析,评价两种吻合方式的优劣。方法:通过计算机检索PubMed、Cochrane Library、EMbase等数据库自建库以来到2018年3月份的所有涉及到胰十二指肠术中比较粘膜对导管吻合法和套入式吻合法的临床研究。采用RevMan 5.3软件对两种术式术后胰漏发生率、重症胰漏发生率、术后并发症发生率、严重并发症发生率、术后死亡率、再次手术率、术后住院时间等相关指标进行统计学分析。结果:在检索的所有文献中共有9篇文献符合纳入标准,共计1219例患者纳入分析。Meta分析结果表明套入式吻合法在术后减少重症胰漏发生率、严重并发症发生率上更具有优势,但无明显统计学差异。而在术后胰漏发生率、术后并发症发生率、术后死亡率、再次手术率、术后住院时间套入式吻合法与导管对粘膜吻合法效果相当。结论:根据现有的证据尚不能证明套入式吻合相对于导管对粘膜吻合法具有明显的优势。 

【文章来源】：重庆医科大学重庆市

【文章页数】：40 页

【学位级别】：硕士

【部分图文】：

不同胰漏定义的两组吻合方式术后胰漏发生率比较森林图Figure4Forestplotofsubgroupsbetweendifferentdefinitionofpancreaticfistulaforthetwo

重庆医科大学硕士研究生学位论文吻合法在总体 PF 的发生率上也无明差异（OR = 0.64，95% CI: 0.30～ 1.36，P =0.25），见图 3，4。图5.两组吻合方式术后重症胰漏发生率比较森林图Figure 5 Forest plot of clinical relevant pancreatic fistula between the two groups

【参考文献】：
期刊论文
[1]Experimental study on operative methods of pancreaticojejunostomy with reference to anastomotic patency and postoperative pancreatic exocrine function[J]. Ming-Dong Bai, Liang-Qun Rong, Lian-Chen Wang, Hai Xu, Rui-Fang Fan, Pei Wang, Xiao-Peng Chen, Liu-Bin Shi, Shu-You Peng Department of General Surgery, The Second Affiliated Hospital, Xuzhou Medical College, Xuzhou 221006, Jiangsu Province, China Department of Hepatobiliary Surgery, Lanzhou General Hospital, Lanzhou Command, PLA, Lanzhou 730050, Gansu Province, China Second Department of Health Care, Lanzhou General Hospital, Lanzhou Command, PLA, Lanzhou 730050, Gansu Province, China Department of General Surgery, Affiliated Yijishan Hospital, Wannan Medical College, Wuhu 241001, Anhui Province, China Department of General Surgery, Affiliated Huashan Hospital, College of Medicine, Fudan University, Shanghai 200433, China Department of General Surgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.  World Journal of Gastroenterology. 2008(03)



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