中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2013年
9期
752-757
,共6页
赵敬柱%高明%于洋%李亦工%李小龙%魏松锋%刘友忠%高健
趙敬柱%高明%于洋%李亦工%李小龍%魏鬆鋒%劉友忠%高健
조경주%고명%우양%리역공%리소룡%위송봉%류우충%고건
甲状腺肿瘤%甲状腺切除术%超声处理%Meta分析
甲狀腺腫瘤%甲狀腺切除術%超聲處理%Meta分析
갑상선종류%갑상선절제술%초성처리%Meta분석
Thyroid neoplasms%Thyroidectomy%Sonication%Meta-analysis
目的 对比分析超声刀与传统手术在甲状腺全切或近全切除术中的安全性及优缺点.方法 全面检索MEDLINE、EMBASE、Cochrane Library等数据库收录的前瞻性随机对照研究的相关文献,排除腔镜及内镜辅助手术及非随机对照研究的文献.采用偏倚风险表对入选文献进行质量评价,从符合要求的文献中提取数据资料,应用RevMan5.2软件进行Meta分析.结果 入选文献13篇,共1620例甲状腺肿瘤患者,其中超声刀手术组802例,传统手术组818例.与传统手术组相比,超声刀组手术时间短,加权均数差(weighted mean difference,WMD)及其95％可信区间(confidence interval,95％ CI)为-21.06[-25.65,-16.47],Z=8.99,P＜0.00001；术中出血量少(WMD及其95％ CI为-14.36[-20.67,-8.06],Z=4.46,P＜0.00001)；术后引流量少(WMD及其95％ CI为-7.47[-11.35,-3.58],Z=3.77,P=0.0002)；住院费用低(WMD及其95％ CI为-117.97[-131.65,-104.29],Z=16.90,P＜0.00001)；术后暂时性喉返神经麻痹、暂时性低钙的发生率两组相似.结论 超声刀组对比传统手术组,手术时间短,术中出血量少,术后引流量少,术后并发症无明显差别,是安全可行的.
目的 對比分析超聲刀與傳統手術在甲狀腺全切或近全切除術中的安全性及優缺點.方法 全麵檢索MEDLINE、EMBASE、Cochrane Library等數據庫收錄的前瞻性隨機對照研究的相關文獻,排除腔鏡及內鏡輔助手術及非隨機對照研究的文獻.採用偏倚風險錶對入選文獻進行質量評價,從符閤要求的文獻中提取數據資料,應用RevMan5.2軟件進行Meta分析.結果 入選文獻13篇,共1620例甲狀腺腫瘤患者,其中超聲刀手術組802例,傳統手術組818例.與傳統手術組相比,超聲刀組手術時間短,加權均數差(weighted mean difference,WMD)及其95％可信區間(confidence interval,95％ CI)為-21.06[-25.65,-16.47],Z=8.99,P＜0.00001；術中齣血量少(WMD及其95％ CI為-14.36[-20.67,-8.06],Z=4.46,P＜0.00001)；術後引流量少(WMD及其95％ CI為-7.47[-11.35,-3.58],Z=3.77,P=0.0002)；住院費用低(WMD及其95％ CI為-117.97[-131.65,-104.29],Z=16.90,P＜0.00001)；術後暫時性喉返神經痳痺、暫時性低鈣的髮生率兩組相似.結論 超聲刀組對比傳統手術組,手術時間短,術中齣血量少,術後引流量少,術後併髮癥無明顯差彆,是安全可行的.
목적 대비분석초성도여전통수술재갑상선전절혹근전절제술중적안전성급우결점.방법 전면검색MEDLINE、EMBASE、Cochrane Library등수거고수록적전첨성수궤대조연구적상관문헌,배제강경급내경보조수술급비수궤대조연구적문헌.채용편의풍험표대입선문헌진행질량평개,종부합요구적문헌중제취수거자료,응용RevMan5.2연건진행Meta분석.결과 입선문헌13편,공1620례갑상선종류환자,기중초성도수술조802례,전통수술조818례.여전통수술조상비,초성도조수술시간단,가권균수차(weighted mean difference,WMD)급기95％가신구간(confidence interval,95％ CI)위-21.06[-25.65,-16.47],Z=8.99,P＜0.00001；술중출혈량소(WMD급기95％ CI위-14.36[-20.67,-8.06],Z=4.46,P＜0.00001)；술후인류량소(WMD급기95％ CI위-7.47[-11.35,-3.58],Z=3.77,P=0.0002)；주원비용저(WMD급기95％ CI위-117.97[-131.65,-104.29],Z=16.90,P＜0.00001)；술후잠시성후반신경마비、잠시성저개적발생솔량조상사.결론 초성도조대비전통수술조,수술시간단,술중출혈량소,술후인류량소,술후병발증무명현차별,시안전가행적.
Objective To compare the safety between harmonic scalpel and conventional resection in total or near total thyroidectomy with meta-analysis.Methods The prospective randomized controlled studies were searched for in electronic databases (MEDLINE,EMBASE,Cochrane Library).Meta analysis of acquired data was performed through the use of RevMan 5.2 software.Results According to the inclusion criterion,13 articles were enrolled which compared on the safety between harmonic scalpel and conventional resection in thyroid surgery.A total of 1620 patients with thyroid tumor were enrolled,including 802 patients in harmonic scalpel group and 818 patients in conventional resection group.Compared with conventional resection group,the harmonic scalpel group showed shorter time of surgery,the weighted mean difference (WMD) and their 95％ confidence interval (95 ％ CI) was-21.06 [-25.65,-16.47],Z =8.99,P ＜0.00001 ; less intra-operative blood loss,WMD and 95％ CI was-14.36[-20.67,-8.06],Z =4.46,P ＜ 0.00001 ; less post-operative drain output (WMD and 95 ％ CI was-7.47 [-11.35,-3.58],Z =3.77,P =0.0002); less hospitalization charges (WMD and 95％ CI was-117.97[-131.65,-104.29],Z =16.90,P ＜ 0.00001).The incidence of postoperative transient recurrent laryngeal nerve dysfunction and transient hypocalcemia were similar in both groups.Conclusion Using the harmonic scalpel in thyroid surgery was as safe as that of the conventional technique with the advantage of shorter time of surgery,less intraoperative blood loss and less postoperative drain output.
