CAJ | 학술논문

目的：评价外膜内外囊切除术与内囊摘除术两种手术方式对于肝包虫病患者的治疗效果。方法通过 Cochrane Library、Medline、EMbase、CNKI、维普以及万方等数据库，检索外膜内外囊切除术（实验组）与内囊摘除术（对照组）在肝包虫病患者中的对照研究，按照 Cochrane 指南进行相关研究的筛选纳入，使用 RevMan V5.2软件进行偏倚风险判断和 Meta 分析，使用 Grade 软件进行证据系统推荐分级。结果共纳入对照研究9项，总体偏倚风险较高，Grade 系统推荐分级为中等及低等。相比于对照组，实验组术后复发率低（RD =-0.15，95％ CI：-0.24~-0.07，P ﹤0.05），术后残腔感染率低（RD =-0.20，95％ CI：-0.24~-0.16，P ﹤0.05），住院时间短（SMD =-1.03，95％CI：-1.71~-0.36，P ﹤0.05），引流管留置时间短（SMD =-10.31，95％ CI：-14.74~-5.87，P ﹤0.05），但是手术时间较长（SMD =3.04，95％ CI：1.26~4.79，P ﹤0.05），术中出血量比较差异无统计学意义（SMD =1.83，95％ CI：-0.15~3.82，P =0.07）。结论对于肝包虫患者采用外膜内外囊切除术相比于内囊摘除术可以获得更好的治疗效果，但是手术难度和风险增加。
목적：평개외막내외낭절제술여내낭적제술량충수술방식대우간포충병환자적치료효과。방법통과 Cochrane Library、Medline、EMbase、CNKI、유보이급만방등수거고，검색외막내외낭절제술（실험조）여내낭적제술（대조조）재간포충병환자중적대조연구，안조 Cochrane 지남진행상관연구적사선납입，사용 RevMan V5.2연건진행편의풍험판단화 Meta 분석，사용 Grade 연건진행증거계통추천분급。결과공납입대조연구9항，총체편의풍험교고，Grade 계통추천분급위중등급저등。상비우대조조，실험조술후복발솔저（RD =-0.15，95％ CI：-0.24~-0.07，P ﹤0.05），술후잔강감염솔저（RD =-0.20，95％ CI：-0.24~-0.16，P ﹤0.05），주원시간단（SMD =-1.03，95％CI：-1.71~-0.36，P ﹤0.05），인류관류치시간단（SMD =-10.31，95％ CI：-14.74~-5.87，P ﹤0.05），단시수술시간교장（SMD =3.04，95％ CI：1.26~4.79，P ﹤0.05），술중출혈량비교차이무통계학의의（SMD =1.83，95％ CI：-0.15~3.82，P =0.07）。결론대우간포충환자채용외막내외낭절제술상비우내낭적제술가이획득경호적치료효과，단시수술난도화풍험증가。
Objective To evaluate the effect of percystectomy and endocystectomy in hepatic echi-nococcosis. Methods All randomized controlled trials were retrieval from the Cochrane Library,Medline, EMbase,CNKI,VIP or Wanfang database,and the date were filtered according to Cochrane guide. The me-ta-analysis was performed by RevMan V5. 2 software and the Grade software was used for recommendation grading. Results There were 9 included studies and the overall risk of bias was high. The recommenda-tion grading is medium and low. Compared with the control group,postoperative recurrence(RD = - 0. 15, 95% CI:-0. 24 ~ -0. 07,P ﹤0. 05),residual cavity infection(RD = - 0. 20,95% CI:- 0. 24 ~ - 0. 16, P ﹤ 0. 05),hospital stay(SMD = - 1. 03,95% CI:- 1. 71 ~ - 0. 36,P ﹤ 0. 05),Drainage tube indwelling time(SMD = - 10. 31,95% CI:- 14. 74 ~ - 5. 87,P ﹤ 0. 05)were superior to the experimental group. But the time of operation was longer than control group(SMD = 3. 04,95% CI:1. 26 ~ 4. 79,P ﹤ 0. 05). There was no statistical significance in the mean bleeding volume(SMD = 1. 83,95% CI:- 0. 15 ~ 3. 82, P =0. 07). Conclusion The effect of percystectomy is superior to endocystectomy in hepatic echinococ-cosis but the operating difficulty and risk also increases.