小兒腹股溝疝腹腔鏡術(shù)與開放性手術(shù)療效和安全性的Meta分析
發(fā)布時間:2018-05-01 22:03
本文選題:腹股溝疝 + 腹腔鏡術(shù)。 參考:《蘭州大學(xué)》2012年碩士論文
【摘要】:目的比較腹腔鏡術(shù)與開放性手術(shù)治療小兒腹股溝疝的療效和安全性。 方法計算機檢索PubMed、EMBASE、Cochrane圖書館、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫、中文科技期刊全文數(shù)據(jù)庫、中國知識基礎(chǔ)設(shè)施工程和萬方數(shù)字化期刊,檢索時間均從建庫至2010年3月。納入有關(guān)腹腔鏡術(shù)與開放性手術(shù)治療小兒腹股溝疝的RCT文獻,根據(jù)Cochrane Handbook5.0.2質(zhì)量評價標準評價納入文獻的質(zhì)量。評價兩種術(shù)式的手術(shù)持續(xù)時間、術(shù)后總并發(fā)癥的發(fā)生率、腹股溝疝的復(fù)發(fā)率、術(shù)后恢復(fù)日;顒訒r間和術(shù)中出血量。采用RevMan5.0軟件對數(shù)據(jù)進行定量合并。 結(jié)果最終納入5篇RCT文獻(共納入586例患兒)。Meta分析結(jié)果顯示:與開放性手術(shù)相比,腹腔鏡術(shù)可以減少術(shù)中出血量[MD=-1.35,95%CI(-1.80,-0.90),P0.00001],但延長了單側(cè)腹股溝疝的手術(shù)持續(xù)時間[MD=10.23,95%CI(4.33,16.14), P=0.0007],不增加腹股溝疝的復(fù)發(fā)率[RR=0.51,95%CI(0.15,1.73), P=0.28]和術(shù)后總并發(fā)癥的發(fā)生率[RR=0.16,95%CI(0.02,1.49), P=0.11],不能縮短術(shù)后恢復(fù)日;顒訒r問[SMD=-0.19,95%CI(-0.49,0.11), P=0.21]。 結(jié)論現(xiàn)有臨床證據(jù)顯示:腹腔鏡術(shù)與開放性手術(shù)相比,可減少術(shù)中出血量,不增加腹股溝疝的復(fù)發(fā)率和術(shù)后總并發(fā)癥的發(fā)生率,但不能縮短術(shù)后恢復(fù)日;顒訒r間,延長了單側(cè)腹股溝疝的手術(shù)持續(xù)時間。期待更多高質(zhì)量、隨訪期長的相關(guān)隨機對照試驗進一步驗證。
[Abstract]:Objective to compare the efficacy and safety of laparoscopic and open operation in the treatment of inguinal hernia in children. Methods A computer-based search was conducted for PubMedus EMBASE Cochrane Library, Chinese Biomedical Literature Database, full text Database of Chinese Science and Technology Journals, Chinese knowledge Infrastructure Engineering and Wanfang Digital Journals. The retrieval time was from the establishment of the database to March 2010. The RCT literature on laparoscopic and open operation for inguinal hernia in children was included, and the quality of the literature was evaluated according to Cochrane Handbook5.0.2 quality evaluation criteria. The duration of the two operations, the incidence of postoperative complications, the recurrence rate of inguinal hernia, the recovery time of daily activities and the amount of intraoperative bleeding were evaluated. RevMan5.0 software was used to combine the data quantitatively. Results five articles of RCT were included. The results of Meta-analysis showed that compared with open surgery, the results of meta-analysis showed that: 1. 鑵硅厰闀滄湳鍙互鍑忓皯鏈腑鍑鴻閲廩MD=-1.35,95%CI(-1.80,-0.90),P0.00001],浣嗗歡闀夸簡鍗曚晶鑵硅偂娌熺枬鐨勬墜鏈寔緇椂闂碵MD=10.23,95%CI(4.33,16.14), P=0.0007],涓嶅鍔犺吂鑲℃矡鐤濈殑澶嶅彂鐜嘯RR=0.51,95%CI(0.15,1.73), P=0.28]鍜屾湳鍚庢,
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