保留肾上腺手术与肾上腺全切除术治疗醛固酮腺瘤疗效比较的meta分析
发布时间：2018-05-02 06:25
本文选题：保留肾上腺手术 + 肾上腺切除术 ； 参考：《解放军医学杂志》2017年05期
【摘要】：目的比较腹腔镜下保留肾上腺与肾上腺全切除术治疗醛固酮腺瘤的围术期安全性及术后疗效。方法在线系统地检索Pub Med、Science Direct、Springerlink、the Cochrane Library、中国知网、中国生物医学文献数据库于2016年5月之前发表的关于保留肾上腺(ASS)或肾上腺部分切除术(PA)对比肾上腺全切除术(TA)治疗醛固酮腺瘤(APA)的文献资料,将入选的研究文献应用Revman 5.3软件进行meta分析,分析的主要内容是围术期结果(手术时间、术中出血量、住院时间)以及术后疗效(治愈率、部分缓解率、无效率)。结果最终共纳入9篇临床研究文献,其中3篇英文文献,6篇中文文献,共包括1036例患者,其中ASS组544例,TA组492例。结果显示,ASS对比TA的手术时间(WMD: 2.09min,95%CI: 9.86~5.67,P=0.60)、术中出血量(WMD:1.13ml,95%CI: 8.86~11.12,P=0.82)、住院时间(WMD: 0.10d,95%CI: 0.32~0.12,P=0.36)差异无统计学意义,而ASS对比TA在治愈率(OR=1.07,95%CI:0.73~1.58,P=0.72)、部分缓解率(OR=0.85,95%CI:0.57~1.27,P=0.43)、无效率(OR=2.15,95%CI:0.32~14.34,P=0.43)差异亦无统计学意义。结论在醛固酮腺瘤的手术治疗中,与肾上腺全切除术比较,保留肾上腺手术技术上安全可靠,术后疗效肯定,二者具有相似的治疗效果,值得进一步在临床上推广。
[Abstract]:Objective to compare the perioperative safety and postoperative efficacy of laparoscopic adrenalectomy and total adrenalectomy for aldosterone adenoma. Methods Pub Medsite Science DirectLink and the Cochrane Library were systematically searched online. The Chinese Biomedical Literature Database published before May 2016 published literature on the treatment of aldosterone adenoma (APA) by preserving the adrenal gland (ASS) or partial adrenalectomy (PAA) compared with total adrenalectomy (TAA). Revman 5.3 software was used for meta analysis. The main contents of the analysis were perioperative results (operative time, intraoperative bleeding volume, hospitalization time) and postoperative efficacy (cure rate, partial remission rate, inefficiency). Results A total of 9 clinical literatures were included, of which 3 were in English and 6 in Chinese, including 1036 cases, including 544 cases in ASS group and 492 cases in TA group. 缁撴灉鏄剧ず,ASS瀵规瘮TA鐨勬墜鏈椂闂，
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