中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2012年
13期
144-147
,共4页
肠梗阻%体层摄影术%X线计算机%Meta分析
腸梗阻%體層攝影術%X線計算機%Meta分析
장경조%체층섭영술%X선계산궤%Meta분석
Intestinal obstruction%Tomography,X-ray computed%Meta-analysis
目的 采用循证医学Meta分析(Meta-analysis)的方法研究绞窄性肠梗阻CT诊断的准确性.方法 收集1990～2011年国内外公开发表的绞窄性肠梗阻CT诊断的文献,并根据QUADAS质量评价标准评价文献的质量,分析偏倚和变异产生的来源,同时对文献间异质性来源进行分析,对产生阈值效应的异质性和其他异质性原因进行Meta-回归分析,并用定量方法SROC对有阈值效应的数值进行合并,对无阈值效应的数据进行随机效应分析(有异质性)和固定效应(无异质性)分析合并.数据分析采用Metadisc 1.4,Excell 2007和Stata 10.0软件,得到合并的SROC曲线,合并的诊断敏感性和特异性,以及合并的阳性和阴性似然比.结果 共检索到文献261篇,符合纳入标准的文献共15篇,均为绞窄性肠梗阻的CT诊断准确且质量较高的研究,合并敏感性为0.698(95％ CI0.655 ～0.739),合并特异性0.904(95％CI0.883 ～0.922),阳性似然比7.418(95％CI4.468～ 12.316),阴性似然比0.228(95％ CI0.129 ～0.404).结论 肠梗阻的CT检查有较高的特异性,但研究有较多的异质性和偏倚,需要进一步研究.
目的 採用循證醫學Meta分析(Meta-analysis)的方法研究絞窄性腸梗阻CT診斷的準確性.方法 收集1990～2011年國內外公開髮錶的絞窄性腸梗阻CT診斷的文獻,併根據QUADAS質量評價標準評價文獻的質量,分析偏倚和變異產生的來源,同時對文獻間異質性來源進行分析,對產生閾值效應的異質性和其他異質性原因進行Meta-迴歸分析,併用定量方法SROC對有閾值效應的數值進行閤併,對無閾值效應的數據進行隨機效應分析(有異質性)和固定效應(無異質性)分析閤併.數據分析採用Metadisc 1.4,Excell 2007和Stata 10.0軟件,得到閤併的SROC麯線,閤併的診斷敏感性和特異性,以及閤併的暘性和陰性似然比.結果 共檢索到文獻261篇,符閤納入標準的文獻共15篇,均為絞窄性腸梗阻的CT診斷準確且質量較高的研究,閤併敏感性為0.698(95％ CI0.655 ～0.739),閤併特異性0.904(95％CI0.883 ～0.922),暘性似然比7.418(95％CI4.468～ 12.316),陰性似然比0.228(95％ CI0.129 ～0.404).結論 腸梗阻的CT檢查有較高的特異性,但研究有較多的異質性和偏倚,需要進一步研究.
목적 채용순증의학Meta분석(Meta-analysis)적방법연구교착성장경조CT진단적준학성.방법 수집1990～2011년국내외공개발표적교착성장경조CT진단적문헌,병근거QUADAS질량평개표준평개문헌적질량,분석편의화변이산생적래원,동시대문헌간이질성래원진행분석,대산생역치효응적이질성화기타이질성원인진행Meta-회귀분석,병용정량방법SROC대유역치효응적수치진행합병,대무역치효응적수거진행수궤효응분석(유이질성)화고정효응(무이질성)분석합병.수거분석채용Metadisc 1.4,Excell 2007화Stata 10.0연건,득도합병적SROC곡선,합병적진단민감성화특이성,이급합병적양성화음성사연비.결과 공검색도문헌261편,부합납입표준적문헌공15편,균위교착성장경조적CT진단준학차질량교고적연구,합병민감성위0.698(95％ CI0.655 ～0.739),합병특이성0.904(95％CI0.883 ～0.922),양성사연비7.418(95％CI4.468～ 12.316),음성사연비0.228(95％ CI0.129 ～0.404).결론 장경조적CT검사유교고적특이성,단연구유교다적이질성화편의,수요진일보연구.
Objective To summarize the accuracy of strangulated obstruction (SO)with meta-analysis for computed tomography examination.Methods Published studies were identified by Pub/Medline and Ovid databases and Chinese databases( 1990-2011 ) to search SO for computed tomography.A standard extractive data were obtained.Inclusion and Extraction criteria were used to extract relevant data,QUADAS was analysed.Using software metadisc 1.4,Excell 2007 and Stata10.0,the summary sensitivity and specificity and summary positive likelihood ratio,summary negative likelihood ratio were caculated,and heterogeneity,biase were also evaluated respectively.Results Of 261 identified studies,15 involving adult patients were considered appropriate for pooled analysis.the pooled sensitivity was 0.698(95％ CI0.655-0.739),and the pooled specificity was 0.904(95％ CI0.883-0.922),The pooled positive likelihood ratio was 7.418(95％ CI 4.468-12.316).The pooled negative likelihood ratio was 0.228(95％ CI,0.129-0.404).Conclusions There are high specificity for SO of CT,but relative low sensitivity;but there were still much biase in these studies,appropriate studies should be evaluated.
