本文選題：電視輔助胸腔鏡手術(shù)　切入點(diǎn)：原發(fā)性自發(fā)性氣胸　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的進(jìn)一步評(píng)價(jià)單孔電視輔助胸腔鏡(VATS)與三孔VATS治療原發(fā)性自發(fā)性氣胸(PSP)的療效。方法計(jì)算機(jī)檢索Pub Med、Cochrane Library、Embase、Science Direct、Web of Science,中國(guó)知網(wǎng)及萬(wàn)方等數(shù)據(jù)庫(kù)中關(guān)于單孔VATS與三孔VATS治療PSP療效對(duì)比的隨機(jī)對(duì)照試驗(yàn)和非隨機(jī)對(duì)照試驗(yàn),檢索時(shí)間為建庫(kù)至2015年9月。由兩位作者按照納入與排除標(biāo)準(zhǔn)篩選文獻(xiàn)、評(píng)價(jià)文獻(xiàn)質(zhì)量、提取資料和評(píng)價(jià)納入研究的偏倚風(fēng)險(xiǎn)。然后使用Rev Man5.20軟件進(jìn)行Meta分析。結(jié)果共納入6篇隊(duì)列研究,共310個(gè)患者。Meta分析研究結(jié)果表明:與三孔VATS治療PSP的療效相比,單孔VATS的平均住院時(shí)間更短[MD=-0.39,95%CI(-0.69,-0.09),P=0.01],術(shù)后24 h疼痛VAS評(píng)分更低[MD=-0.78,95%CI(-1.40,-0.52),P0.00001],胸腔引流時(shí)間更短[MD=-0.68,95%CI(-1.15,-0.22),P=0.004],術(shù)后皮膚感覺(jué)異常發(fā)生率更低[OR=0.13,95%CI(0.06,0.29),P0.00001]。然而,與三孔VATS相比,單孔VATS在術(shù)后24 h[MD=-0.65,95%CI(-0.95,-0.35),P0.0001]和48 h[MD=-0.46,95%CI(-0.71,-0.21),P=0.0002]的病人滿意度評(píng)分較低。兩組在氣胸復(fù)發(fā)率[OR=0.58,95%CI(0.20 to 1.67),P=0.32]、手術(shù)時(shí)間[MD=-1.01,95%CI(-4.63,2.60),P=0.58]和術(shù)后72 h[MD=-0.11,95%CI(-0.44,0.22),P=0.50]病人滿意度評(píng)分方面,差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論單孔VATS與三孔VATS治療PSP的療效相比,單孔VATS的治療效果更有優(yōu)勢(shì)。但仍然還需更大規(guī)模和更高質(zhì)量的研究進(jìn)行論證。
[Abstract]:Objective to further evaluate the efficacy of single hole video-assisted thoracoscopy (VATS) and three-hole VATS in the treatment of primary spontaneous pneumothorax (PSP). Methods to search the Pub Medchrane Library Embase Science Direct Science Web of Science of Science in the database of single hole VATS and three-hole VATS. A randomized controlled trial and a non-randomized controlled trial to compare the efficacy of PSP, The retrieval time was from the establishment of the database to September 2015. According to the criteria of inclusion and exclusion, the two authors screened the literature and evaluated the quality of the literature. Data were extracted and evaluated for bias risk in the study. Then Meta analysis was performed using Rev Man5.20 software. The results were included in 6 cohort studies. The results of a total of 310 patients. Meta-analysis showed that: compared with three-hole VATS treatment of PSP, the results showed that: 1. The average hospitalization time of single-hole VATS was shorter [MD-0.39-95CI-0.69C -0.09 P0.01], the VAS score of pain was lower 24 hours after operation [MD-0.7895 CIG-1.40 ~ -0.52C P0.00001], the time of thoracic drainage was shorter [MD-0.6895CI-1.15CI-0.22Pao 0.004], and the incidence of skin sensory abnormality was lower [OR0.1395CI0.060.29P0.00001]. However, compared with three-hole VATS, the incidence of abnormal skin sensation was lower [0.1395CI0.060.29P0.00001]. The satisfaction scores of patients with single-hole VATS were lower 24 hours after operation [MD-0.65CI-0.95 CI-0.95- 0.35C P0.0001] and 48h [MD-0.4695 CI-0.21CI-0.21CI-0.0002]. The two groups had lower satisfaction scores in the rate of pneumothorax recurrence [OR0.5895CI0.20 to 1.67CI0.32], the time of operation [MD-1.01CI-4.63CI-4.632.60P0.58] and the 72 h after operation [MD-0.1195CI-0.44440.220.22 / 0.50]. Conclusion compared with three-hole VATS, single-hole VATS is more effective than three-hole VATS in the treatment of PSP.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R655

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