本文關(guān)鍵詞： 胰十二指腸切除術(shù) 術(shù)前膽道引流 梗阻性黃疸 并發(fā)癥　出處：《南昌大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評估術(shù)前膽道引流(preoperative biliary drainage,PBD)的療效,對低位梗阻性黃疸患者行胰十二指腸切除術(shù)(Pancreaticoduodenectomy,PD)后并發(fā)癥及預(yù)后的系統(tǒng)評價(jià)。方法:根據(jù)Cochrane系統(tǒng)評價(jià)的要求,從Pub Med、MEDLINE、Embase數(shù)據(jù)庫、CNKI(中國期刊知網(wǎng))、萬方數(shù)據(jù)庫等,檢索2004年至今的中英文文獻(xiàn)臨床對照研究。用Rev Man5.2軟件對胰十二指腸切除術(shù)后并發(fā)癥及預(yù)后的薈萃分析。結(jié)果:最終符合入選標(biāo)準(zhǔn)的19篇文獻(xiàn),共有2235例梗阻性黃疸患者被納入研究,其中術(shù)前膽道引流(preoperative biliary drainage,PBD)組有1018例患者包括內(nèi)引流或外引流,非術(shù)前膽道引流(no preoperative biliary drainage,NPBD)組1217例患者。19項(xiàng)研究中有5項(xiàng)是只采用內(nèi)引流方式,其余14項(xiàng)都采用內(nèi)引流或外引流。分別對患者PD術(shù)后并發(fā)癥(傷口感染、腹腔出血、腹腔感染、消化道出血、胃排空障礙、膽漏、胰漏和總并發(fā)癥)和死亡率進(jìn)行薈萃分析,經(jīng)Meta分析顯示:PD前行PBD與NPBD兩組間傷口感染、腹腔出血、腹腔感染、消化道出血、胃排空障礙、膽漏、胰漏和總并發(fā)癥等差異無統(tǒng)計(jì)學(xué)意義(P0.05),PBD組術(shù)后死亡率(OR=0.59,95%CI=0.37~0.94,P=0.03)PBD組死亡率低于NPBD組,有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:PD術(shù)前行PBD不能顯著降低術(shù)后并發(fā)癥的發(fā)生率但可以使PD術(shù)后死亡率降低。
[Abstract]:Objective: to evaluate the effect of preoperative biliary drainage and preoperative biliary drainage, and to evaluate the complications and prognosis of patients with low obstructive jaundice after pancreaticoduodenectomy. Methods: according to the requirements of Cochrane system evaluation, From Pub MedMed MEDLINEN Embase database, CNKI (Chinese Journal knowledge Network, Wanfang Database, etc.), To retrieve the clinical comparative study of Chinese and English literature from 2004 to present. A meta-analysis of complications and prognosis after pancreaticoduodenectomy was performed with Rev Man5.2 software. A total of 2235 patients with obstructive jaundice were included in the study. 1018 patients in the preoperative biliary drainage preoperative biliary drainage group included internal or external drainage. In the non-preoperative preoperative biliary drainage group, 5 of 1217 patients were treated with internal drainage only, the remaining 14 patients were treated with internal drainage or external drainage. The complications (wound infection, intraperitoneal hemorrhage, abdominal cavity infection, abdominal cavity infection) after PD were observed. A meta-analysis of gastrointestinal bleeding, gastric emptying disorder, bile leakage, pancreatic leakage and total complications) and mortality were performed. Meta analysis showed that there were wound infection, abdominal hemorrhage, abdominal infection, gastrointestinal hemorrhage, gastric emptying disorder between PBD and NPBD groups. There was no significant difference in postoperative mortality between PBD group (P 0.05) and total complication (P 0.05). The mortality rate in PBD group was lower than that in NPBD group. Conclusion PBD before PBD can not significantly reduce the incidence of postoperative complications but can reduce the postoperative mortality.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R657.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 徐再玲;蔡建庭;;內(nèi)鏡減黃治療對胰十二指腸切除術(shù)早期并發(fā)癥的意義[J];中華消化雜志;2013年06期

2 孫孝文;單毅;;術(shù)前膽道引流對低位惡性膽道梗阻患者行胰十二指腸切除術(shù)后的影響[J];國際消化病雜志;2012年02期

3 王劍雄;孔棣;;術(shù)前減黃及相關(guān)因素對壺腹周圍癌胰十二指腸切除術(shù)后并發(fā)癥的影響[J];重慶醫(yī)學(xué);2011年32期

4 Sheikh Anwar Abdullah;Tarun Gupta;Khairul Azhar Jaafar;Yaw Fui Alexander Chung;London Lucien Peng Jin Ooi;Steven Joseph Mesenas;;Ampullary carcinoma:Effect of preoperative biliary drainage on surgical outcome[J];World Journal of Gastroenterology;2009年23期

5 劉永鋒;宋少偉;;惡性梗阻性黃疸病人術(shù)前減黃治療的有關(guān)問題[J];中國實(shí)用外科雜志;2007年10期

6 Chandra Shekhar Bhati;Chandrashekhar Kubal;Pankaj Kumar Sihag;Ankur Atal Gupta;Raj Kamal Jenav;Nicholas G Inston;Jagdish M Mehta;;Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy[J];World Journal of Gastroenterology;2007年08期

7 畢新宇,邵永孚,蔡建強(qiáng),趙平;術(shù)前減黃對重癥黃疸患者行胰十二指腸切除術(shù)的影響[J];中國普通外科雜志;2004年06期

8 黃建富,陳燕凌,黃長玉,沈娟;胰腸吻合套入式的胰十二指腸切除術(shù)[J];中華普通外科雜志;2000年08期

9 彭淑牖,吳育連,彭承宏,江獻(xiàn)川,牟一平,王家驊,蔡秀軍,李君達(dá),陸松春,徐明坤;捆綁式胰腸吻合術(shù)(附 28 例報(bào)告)[J];中華外科雜志;1997年03期

10 陳東;梁力建;何耀彬;崔景華;;術(shù)前減黃對低位膽道惡性梗阻性黃疸患者行胰十二指腸切除術(shù)的影響[J];中華普通外科雜志;2007年02期

，

本文編號(hào)：1501518