中国临床新医学
中國臨床新醫學
중국림상신의학
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
2015年
5期
422-427
,共6页
孙欣%郭建昇%贾文斌%李文斐
孫訢%郭建昇%賈文斌%李文斐
손흔%곽건승%가문빈%리문비
腹腔镜修补术%消化性溃疡穿孔%Meta分析
腹腔鏡脩補術%消化性潰瘍穿孔%Meta分析
복강경수보술%소화성궤양천공%Meta분석
Laparoscopic repair%Perforated peptic ulcer%Meta-analysis
目的:系统评价腹腔镜与开腹修补术治疗消化性溃疡穿孔的安全性及有效性。方法收集1990-01~2014-09公开发表的有关两种治疗方法的中文和英文文献并进行疗效比较分析。结果该研究共纳入6篇随机对照试验,共计682例患者,其中腹腔镜组362例,开腹组320例。 Meta分析结果显示,腹腔镜与开腹消化性溃疡穿孔修补术比较,腹腔镜组术中出血量少( P=0.000)、肠蠕动恢复时间短( P=0.002)、住院时间短(P=0.000),术后主要并发症如切口感染(P=0.000)、肺部感染(P=0.04)、术后肠梗阻(P=0.03)发生率低,而在手术时间(P=0.37)、腹腔脓肿(P=0.57)、术后死亡率(P=0.34)方面,两组之间差异无统计学意义。结论腹腔镜手术治疗消化性溃疡穿孔创伤更小、出血量更少、术后恢复更快、术后主要并发症发生率较低,是一种安全可行的治疗手段。
目的:繫統評價腹腔鏡與開腹脩補術治療消化性潰瘍穿孔的安全性及有效性。方法收集1990-01~2014-09公開髮錶的有關兩種治療方法的中文和英文文獻併進行療效比較分析。結果該研究共納入6篇隨機對照試驗,共計682例患者,其中腹腔鏡組362例,開腹組320例。 Meta分析結果顯示,腹腔鏡與開腹消化性潰瘍穿孔脩補術比較,腹腔鏡組術中齣血量少( P=0.000)、腸蠕動恢複時間短( P=0.002)、住院時間短(P=0.000),術後主要併髮癥如切口感染(P=0.000)、肺部感染(P=0.04)、術後腸梗阻(P=0.03)髮生率低,而在手術時間(P=0.37)、腹腔膿腫(P=0.57)、術後死亡率(P=0.34)方麵,兩組之間差異無統計學意義。結論腹腔鏡手術治療消化性潰瘍穿孔創傷更小、齣血量更少、術後恢複更快、術後主要併髮癥髮生率較低,是一種安全可行的治療手段。
목적:계통평개복강경여개복수보술치료소화성궤양천공적안전성급유효성。방법수집1990-01~2014-09공개발표적유관량충치료방법적중문화영문문헌병진행료효비교분석。결과해연구공납입6편수궤대조시험,공계682례환자,기중복강경조362례,개복조320례。 Meta분석결과현시,복강경여개복소화성궤양천공수보술비교,복강경조술중출혈량소( P=0.000)、장연동회복시간단( P=0.002)、주원시간단(P=0.000),술후주요병발증여절구감염(P=0.000)、폐부감염(P=0.04)、술후장경조(P=0.03)발생솔저,이재수술시간(P=0.37)、복강농종(P=0.57)、술후사망솔(P=0.34)방면,량조지간차이무통계학의의。결론복강경수술치료소화성궤양천공창상경소、출혈량경소、술후회복경쾌、술후주요병발증발생솔교저,시일충안전가행적치료수단。
Objective To study the safety and efficacy of laparoscopy and open repair for patients with perfo-rated peptic ulcer.Methods Articles published in Chinese and English were searched in the Cochrane Library and on the databases of PubMed, EMBASE, CNKI, Wanfang from January 1990 to September 2014, to meet the search-ing requirements.Meta-analysis was used to analyze the collected data.Results The data of 6 randomized clinical trials of acceptable quality were collected from the databases,including a total of 682 patients, 362 cases of laparo-scopic group and 320 cases of open group.The results showed that there were no statistically significant differences between laparoscopic and open surgery in the operative time(P=0.37), intra-abdominal abscess(P=0.57) and mor-tality(P=0.34).Conclusion Laparoscopic surgery is safe and feasible.However, more randomized controlled tri-als with a greater number of patients need to be performed to confirm such an assumption.