CAJ | 학술논문

目的：对比分析超声刀与电刀在乳腺癌改良根治术中的安全性及优缺点。方法：计算机全面检索MEDLINE、EMBASE、Cochrane library、万方、CNKI、CBM数据库，查找比较超声刀和电刀在乳腺癌改良根治术中应用的前瞻性对照试验。对入选文献进行质量评价后，从符合要求的文献中提取数据资料，采用RevMan5软件进行Meta分析。结果：纳入11项合格研究，共817例乳腺癌患者。其中超声刀手术组404例，传统电刀手术组413例。Meta结果显示：与电刀手术组相比，超声刀组术中出血量明显减少、淋巴结检出数目多。在手术时间、术后引流量、引流天数和皮下积液发生方面略优于电刀组。结论：在乳腺癌改良根治术中超声刀对比电刀组，术中出血少，淋巴结检出数目多，安全可行。受限于纳入文章的质量和研究数量，上述结论尚需进一步多中心、大样本、高质量的前瞻性研究加以证实。
목적：대비분석초성도여전도재유선암개량근치술중적안전성급우결점。방법：계산궤전면검색MEDLINE、EMBASE、Cochrane library、만방、CNKI、CBM수거고，사조비교초성도화전도재유선암개량근치술중응용적전첨성대조시험。대입선문헌진행질량평개후，종부합요구적문헌중제취수거자료，채용RevMan5연건진행Meta분석。결과：납입11항합격연구，공817례유선암환자。기중초성도수술조404례，전통전도수술조413례。Meta결과현시：여전도수술조상비，초성도조술중출혈량명현감소、림파결검출수목다。재수술시간、술후인류량、인류천수화피하적액발생방면략우우전도조。결론：재유선암개량근치술중초성도대비전도조，술중출혈소，림파결검출수목다，안전가행。수한우납입문장적질량화연구수량，상술결론상수진일보다중심、대양본、고질량적전첨성연구가이증실。
Objective:To compare the safety between harmonic scalpel and electrocautery in modified radical mas-tectomy using meta-analysis. Methods:MEDLINE,EMBASE,Cochrane library,Wanfang,CNKI,CBM were searched for the prospective controlled trials of ultrasonic dissection versus electrocautery for mastectomy. Then,assess the qual-ities of the included trials and perform a meta-analysis with Revman5 software. Results:Eleven trials were included in the analysis with 817 mastectomies,involving 404 cases in harmonic scalpel group and 413 cases in controls. Meta-analysis showed that,compared with electrocautery group,the harmonic scalpel group showed more less intra-oper-ative blood loss,more number of lymph nodes detected,operative time,total postoperative drainage,drainage days and seroma development were slightly superior to control group. Conclusion:Ultrasonic dissection in modified radical mas-tectomy was as safe as that of the electrocautery with the advantage of less intra-operative blood loss and more num-ber of lymph nodes detected. But limited by the quantity and quality of studies included,larger sample,high quality RCTs are needed to verify the conclusion.