【摘要】：目的系統(tǒng)評價內(nèi)科胸腔鏡(Medical Thoracoscopy,MT)輔助治療結(jié)核性胸腔積液(Tuberculous Pleural Effusion,TPE)的有效性。方法計算機檢索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、WanFang Data、CBM和VIP數(shù)據(jù)庫,檢索關(guān)于MT輔助治療TPE的相關(guān)研究文獻,檢索時限均從建庫至2016年12月10日。由2位評價員按照納入與排除標準獨立篩選文獻、提取資料并評價納入研究的方法學質(zhì)量后,采用RevMan5.3軟件進行Meta分析。結(jié)果共納入21個研究,1858例患者。Meta分析結(jié)果顯示:與N-MT相比,MT輔助治療TPE在有效率[OR=15.13,95%CI(8.11,28.23),P0.00001],胸水總引流量[MD=465.30,95%CI(273.07,657.54),P0.00001],胸水消退時間[MD=-7.83,95%CI(-11.56,-4.11),P0.0001],住院時間[MD=-4.42,95%CI(-7.39,-1.44),P=0.004],肺功能FEV1%改善率[MD=4.79,95%CI(2.46,7.11),P0.0001]及肺功能FVC%改善率[MD=6.68,95%CI(4.61,8.76),P0.00001],胸膜厚度[MD=-0.76,95%CI(-0.99,-0.52),P0.00001]、胸膜增厚發(fā)生率[OR=0.27,95%CI(0.14,0.55),P=0.0003]及轉(zhuǎn)手術(shù)率[OR=0.24,95%CI(0.15,0.41),P0.00001],臨床癥狀消失時間[MD=-5.31,95%CI(-9.09,-1.53),P=0.006],拔管時間[MD=-6.24,95%CI(-6.61,-5.86),P0.00001],包裹性胸腔積液復發(fā)率[OR=0.37,95%CI(0.19,0.72),P=0.003]等方面,差異有統(tǒng)計學意義;但在不良反應(yīng)發(fā)生方面,MT輔助治療包裹性TPE[OR=0.80,95%CI(0.31,2.03),P=0.63]方面,差異無統(tǒng)計學意義。結(jié)論現(xiàn)有證據(jù)表明,MT輔助治療TPE效果良好且并發(fā)癥少,值得臨床應(yīng)用開展。鑒于納入研究數(shù)量有限,上述結(jié)論尚需開展更多研究予以驗證。
[Abstract]:Objective to evaluate the efficacy of medical Thoracos copyMT in the treatment of tuberculous pleural effusion (TPE). Methods the CBM and VIP databases of the Cochrane Library Web of Science and Technology were searched by computer, and the relevant literatures on MT adjuvant treatment of TPE were searched. The retrieval time was from the establishment of the library to December 10, 2016. After two evaluators independently sifted the literature according to the inclusion and exclusion criteria, extracted the data and evaluated the methodological quality of the study, the meta-analysis was carried out with Revman 5.3 software. 緇撴灉鍏辯撼鍏，

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