【摘要】：目的:評價ALPPS一期手術(shù)中完全斷肝法與非完全斷肝法之間的安全性。方法:計算機檢索Pubmed、Google Scholar、CNKI、萬方等數(shù)據(jù)庫,收集所有2017年2月以前關(guān)于對比ALPPS一期手術(shù)中完全斷肝法和非完全斷肝法比較的臨床對比研究,進行文獻篩選和資料提取,對文獻數(shù)據(jù)使用RevMan5.3進行分析。結(jié)果:共納入5篇臨床對比研究,包含完全離斷組86例,非完全斷肝組74例,meta分析結(jié)果:完全斷肝組在FLR增長率(P=0.16)、二步手術(shù)時間間隔(P=0.34)、術(shù)后院內(nèi)死亡率(P=0.24)上的差異無統(tǒng)計學(xué)意義,但術(shù)后嚴(yán)重并發(fā)癥(Grade≥3b)發(fā)生率高于非完全斷肝組,比值比2.99,95%CI(1.04,8.58),P=0.04。結(jié)論:完全斷肝法雖然在術(shù)后并發(fā)癥發(fā)生率上高于非完全斷肝組,但在院內(nèi)死亡率上無明顯差異,其安全性仍需更多大樣本、多中心隨機對照試驗進一步證實。
[Abstract]:Objective: To evaluate the safety of complete liver disconnection and incomplete liver disconnection during the first phase of ALPPS operation. Methods: a computer retrieval of Pubmed, Google Scholar, CNKI, Wan Fang and other databases were used to collect all clinical comparative studies on the comparison of complete and non complete liver disconnection in the first phase of ALPPS operation before February 2017, and the literature screening was carried out. And data extraction, the literature data using RevMan5.3 analysis. Results: a total of 5 clinical comparative studies, including 86 cases of complete disconnection group, 74 cases of complete disconnection group, 74 cases of incomplete liver disconnection, meta analysis results: complete liver fault group in FLR growth rate (P=0.16), two step operation time interval (P= 0.34), postoperative hospital mortality (P=0.24) difference is not statistically significant. However, the incidence of postoperative severe complications (Grade > 3b) was higher than that in the non complete liver failure group, and the ratio ratio was 2.99,95%CI (1.04,8.58). Conclusion: Although the rate of postoperative complications was higher than that of the non complete liver failure group, there was no significant difference in the mortality rate in the hospital, and the safety of the complete liver failure still needed more large samples and a multi center randomized controlled trial. Step by step.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R657.3

【參考文獻】

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1 胡志剛;黃拼搏;周振宇;何傳超;張賀云;李文濱;肖治宇;張建龍;徐捚耀;徐康;方馳華;王捷;;二維影像技術(shù)和三維可視化技術(shù)輔助ALPPS治療肝癌效果的初步探討[J];中華外科雜志;2016年09期

2 黃乾榮;張玲;;原發(fā)性肝癌治療研究新進展[J];實用醫(yī)學(xué)雜志;2016年14期

3 徐意瑤;盧欣;楊華瑜;毛一雷;桑新亭;趙海濤;徐海峰;遲天毅;杜順達;鐘守先;黃潔夫;;ALPPS技術(shù)在肝癌合并肝硬化手術(shù)中的應(yīng)用[J];中華普通外科雜志;2016年07期

4 侯俊光;沈顏芹;;肝纖維化程度對行腹腔鏡下ALPPS術(shù)巨塊型原發(fā)性肝癌患者臨床指標(biāo)的影響[J];中國醫(yī)藥導(dǎo)刊;2016年06期

5 陳亞進;黃拼搏;王捷;;聯(lián)合肝臟離斷和門靜脈結(jié)扎二步肝切除術(shù)焦點問題的探討[J];外科理論與實踐;2016年03期

6 陳亞進;曹君;;損傷控制理念下聯(lián)合肝臟分隔和門靜脈結(jié)扎的二步肝切除術(shù)手術(shù)方式改進[J];中華消化外科雜志;2016年05期

7 劉連新;;聯(lián)合肝臟分隔和門靜脈結(jié)扎的二步肝切除術(shù)基礎(chǔ)研究進展[J];中華消化外科雜志;2016年05期

8 王強;閆軍;馮曉彬;陳耿;李曉武;夏鋒;譚運華;蔣家云;馬寬生;別平;;射頻輔助的ALPPS治療合并肝硬化的原發(fā)性肝癌——我們的初步經(jīng)驗[J];中國普外基礎(chǔ)與臨床雜志;2016年01期

9 蔡秀軍;彭淑牖;虞洪;李哲勇;洪強;;完全腹腔鏡下行ALPPS治療伴肝硬化的原發(fā)性肝癌可行性臨床探討[J];中國實用外科雜志;2014年07期

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