發(fā)布時(shí)間：2018-05-08 18:41

  本文選題：擇期肝臟切除術(shù) + 腹腔引流管　； 參考：《現(xiàn)代預(yù)防醫(yī)學(xué)》2017年11期

【摘要】：目的系統(tǒng)評價(jià)擇期肝臟切除術(shù)后的病人常規(guī)安置腹腔引流管(RAD)與未安置引流管(NRAD)的差別,為臨床醫(yī)師合理選擇處理方法提供循證醫(yī)學(xué)證據(jù)。方法檢索國內(nèi)外各大數(shù)據(jù)庫及各類會議論文,查找采用隨機(jī)或半隨機(jī)方法比較肝臟切除術(shù)后是否安置腹腔引流管的研究,并對所有的納入研究進(jìn)行分析以及質(zhì)量評價(jià),采用Cochrane library提供的軟件進(jìn)行分析。結(jié)果研究最后納入文獻(xiàn)9篇,共包括1 418例患者,其中RAD組851例,NRAD組567例。結(jié)果表明:與RAD組相比,NRAD組感染性腹腔積液的發(fā)生率更低[RR=2.38,95%CI(1.20,4.71),P=0.01]。其他臨床觀察指標(biāo)如術(shù)后死亡、再手術(shù)、需要額外處理的腹腔積液、傷口感染、膽漏等的發(fā)生率在兩組間比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論當(dāng)經(jīng)驗(yàn)豐富的外科醫(yī)生對術(shù)中情況滿意時(shí),擇期肝臟切除的患者并非需要常規(guī)預(yù)防性安置腹腔引流管,該結(jié)論仍需要更大樣本的隨機(jī)對照試驗(yàn)進(jìn)行驗(yàn)證。
[Abstract]:Objective to systematically evaluate the difference between conventional placement of abdominal drainage tube (RAD) and non-implanted drainage tube (NRAD) in patients after elective hepatectomy, and to provide evidence for clinicians to choose reasonable treatment methods. Methods We searched all kinds of databases and conference papers at home and abroad to find out whether the abdominal drainage tube was placed after hepatectomy by random or semi-random method, and to analyze and evaluate the quality of all the included studies. The software provided by Cochrane library is used to analyze. Results at the end of the study, 9 articles were included, including 1 418 patients, including 851 cases in RAD group and 567 cases in NRAD group. The results showed that the incidence of infective peritoneal effusion in RAD group was lower than that in RAD group. There was no significant difference between the two groups in the incidence of other clinical indicators such as postoperative death reoperation abdominal effusion which needed extra treatment wound infection and bile leakage. Conclusion when an experienced surgeon is satisfied with the operation, the patients undergoing selective hepatectomy do not require routine preventive placement of the peritoneal drainage tube. This conclusion still needs to be verified by a larger sample of randomized controlled trials.
【作者單位】： 西南醫(yī)科大學(xué)附屬醫(yī)院肝膽外科;
【分類號】：R657.3

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