食管癌切除术后吻合口瘘危险因素的Meta分析
发布时间：2018-05-14 16:49
本文选题：食管癌 + 吻合口瘘 ； 参考：《河南科技大学》2015年硕士论文
【摘要】：目的:对食管癌术后吻合口瘘发生的危险因素进行系统评价,进一步探讨吻合口瘘发生的相关因素,对于有效预防并降低吻合口瘘的发生率具有重要意义。方法:纳入分析食管癌(食道癌)术后吻合口瘘(漏)的危险因素的临床研究。通过以下电子检索数据库Cochrane图书馆、MEDLINE(1993~2014.07)、EMBASE(1993~2014.07)、中国生物医学文献光盘数据库(1993~2014.07)、中文学术期刊全文数据库(1993~2014.07)、中文科技期刊全文数据库(1993~2014.07),中文生物医学期刊数据库(1993~2014.07)、万方数据库。对临床研究进行质量评估后,应用Cochrane协作网提供的Review Manger5.0软件包对其危险因素进行分析,计算比值比(Odds Ratio,OR)。结果:据纳入及排除标准,经筛选后纳入Meta-分析的文献24篇。男性食管癌患者吻合口瘘的发生率高于女性但不具有统计学意义,(P=0.05)合并OR值为0.73(95%CI:0.54~1.00);年龄≥60岁的食管癌患者吻合口瘘的发生率高于60岁以下患者,但不具有统计学意义,(P0.05),合并OR值为0.79(95%CI:0.56~1.10)⺄术前患有糖尿病的食管癌患者吻合口瘘发生率高于非糖尿病者,合并OR值为2.40(95%CI:1.64~3.52,P0.01)⺄术前血清白蛋白≥35g/L的食管癌患者吻合口瘘发生率低于35g/L者,合并OR值为15.06(95%CI:9.82~23.10,P0.01);术前合并呼吸系统疾病的食管癌患者吻合口瘘发生率高于无呼吸系统疾病者,合并OR值为10.04(95%CI:6.92~14.58,P0.01);术前患有高血压病的食管癌患者吻合口瘘发生率高于非高血压病者,合并OR值为2.40(95%CI:1.64~3.52,P0.01);术前行新辅助放疗的食管癌患者吻合口瘘的发生率高于未接受新辅助放疗者,合并OR值为7.21(95%CI:3.20~16.20,P0.01);食管癌分期Ⅰ、Ⅱ的食管癌患者吻合口瘘发生率低于Ⅲ、Ⅳ期患者,合并OR值为0.23(95%CI:0.16~0.33,P0.01);手术时间4.5h的食管癌患者吻合口瘘的发生率低于手术时间≥4.5h者,合并OR值为0.25(95%CI:0.16~0.37,P0.01);手工吻合的食管癌患者吻合口瘘发生率高于吻合器吻合者,合并OR值为0.61(95%CI:0.43~0.86,P0.01);经胸骨后颈部吻合的食管癌患者吻合口瘘发生率高于经食管床颈部吻合者,合并OR值为3.20(95%CI:2.41~4.25,P0.01)。结论:初步确定糖尿病、术前血清白蛋白35g/L、呼吸系统疾病、高血压病、术前新辅助放疗、食管癌Ⅲ、Ⅳ期、手术时间≥4.5h、手工吻合、经胸骨后颈部吻合是食管癌术后吻合口瘘的危险因素。
[Abstract]:Objective: to evaluate the risk factors of anastomotic fistula after esophageal cancer operation, and to further explore the related factors of anastomotic fistula, which is of great significance to effectively prevent and reduce the incidence of anastomotic fistula. Methods: to analyze the risk factors of anastomotic leakage after esophageal carcinoma operation. Through the following electronic retrieval database, Cochrane Library, Cochrane Library, Cochrane Library, China Biomedical Literature CD-ROM database, Chinese academic journal full text database, Chinese Science and Technology Journal Full-text Database, Chinese Biomedical Journals Database, Chinese Biomedical Journal Database, 1993 / 3 / 2014 / 07, Chinese Biomedical Journal Database, China Biomedical Journals Database No., 1993 / 04 / 07, Chinese Biomedical Journal Database, China Biomedical Journal Database, 1993,2014.07, Chinese Biomedical Journal Database No., 1993 / 04 / 07, Chinese Biomedical Journal Database, China Biomedical Journals Database, Chinese Biomedical Journals Database. After the quality evaluation of clinical research, the risk factors were analyzed by Review Manger5.0 software package provided by Cochrane cooperation network, and the ratio of odds ratio was calculated. Results: according to inclusion and exclusion criteria, 24 articles were selected and included in Meta-analysis. The incidence of anastomotic fistula in male patients with esophageal cancer was higher than that in women but not statistically significant (OR = 0.7395 CI: 0.541.00), and the incidence of anastomotic fistula in patients with esophageal cancer 鈮，
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