保留十二指腸的胰頭切除術(shù)與胰十二指腸切除術(shù)治療慢性胰腺炎的Meta分析
發(fā)布時間：2018-12-11 05:04
【摘要】：目的:通過Meta分析,對胰十二指腸切除術(shù)(保留或不保留幽門,pylorus-preserving pancreatoduodenectomy,PPPD/pancreatoduodenectomy,PD)與保留十二指腸的胰頭切除術(shù)(duodenum-preserving pancreatic head resection,DPPHR)治療慢性胰腺炎的安全性和有效性進行評價。方法:在Pubmed、EMbase、Springer-Link、The Cochrane Library上系統(tǒng)檢索關(guān)于PPPD/PD與DPPHR治療慢性胰腺炎的隨機對照試驗(randomized controlled trial,RCT),根據(jù)Cochrane Handbook 5.1對納入的文獻進行偏倚風(fēng)險評估。統(tǒng)計學(xué)軟件選用Rev Man 5.3,對兩種術(shù)式的圍術(shù)期死亡率、術(shù)后疼痛緩解、術(shù)后胰腺內(nèi)、外分泌功能障礙和整體生活質(zhì)量等方面的數(shù)據(jù)進行處理和分析。結(jié)果:共有7個隨機對照試驗,366例患者被納入分析。PPPD/PD組與DPPHR組比較,在術(shù)后疼痛緩解(RR=0.92,P=0.26)、圍術(shù)期死亡率(RR=0.75,P=0.45)、術(shù)后新發(fā)胰腺內(nèi)分泌功能障礙(RR=1.30,P=0.15)、術(shù)后新發(fā)胰腺外分泌功能障礙(RR=2.43,P=0.10)、術(shù)后總并發(fā)癥發(fā)生情況(RR=1.70,P=0.13)等方面的差異無統(tǒng)計學(xué)意義;在術(shù)后恢復(fù)工作(RR=0.72,P=0.008)、整體生活質(zhì)量(WMD=-12.06,P0.01)、體重增加(WMD=-4.16,P0.01)和手術(shù)時間(WMD=101.53,P0.01)方面的差異有統(tǒng)計學(xué)意義,顯示DPPHR組要優(yōu)于PPPD/PD組。結(jié)論:DPPHR與PPPD/PD在圍術(shù)期死亡率、術(shù)后疼痛緩解、術(shù)后新發(fā)胰腺內(nèi)、外分泌功能障礙、術(shù)后總并發(fā)癥方面同樣安全和有效,但DPPHR在手術(shù)時間、術(shù)后體重增加情況、術(shù)后工作恢復(fù)情況等方面較PPPD/PD有優(yōu)勢,能明顯改善患者術(shù)后的整體生活質(zhì)量。
[Abstract]:Objective: to analyze the relationship between pancreaticoduodenectomy (pylorus-preserving pancreatoduodenectomy,PPPD/pancreatoduodenectomy,PD) and duodenal preserving pancreatectomy (duodenum-preserving pancreatic head resection,) by Meta analysis. To evaluate the safety and efficacy of DPPHR in the treatment of chronic pancreatitis. Methods: a randomized controlled trial (randomized controlled trial,RCT) of PPPD/PD and DPPHR in the treatment of chronic pancreatitis was systematically searched on Pubmed,EMbase,Springer-Link,The Cochrane Library. The risk of bias was evaluated according to Cochrane Handbook 5.1. The data of perioperative mortality, postoperative pain relief, pancreatic dysfunction, exocrine dysfunction and overall quality of life were analyzed with Rev Man 5.3. Results: there were 7 randomized controlled trials in which 366 patients were included in the analysis. Pain relief (RR=0.92,P=0.26), perioperative mortality (RR=0.75,P=0.45), postoperative pain relief (RR=0.92,P=0.26) and perioperative mortality (RR=0.75,P=0.45) in the PPPD/PD group were compared with those in the DPPHR group. Postoperative pancreatic endocrine dysfunction (RR=1.30,P=0.15), postoperative pancreatic exocrine dysfunction (RR=2.43,P=0.10), total postoperative complications (RR=1.70,) There was no significant difference in P0. 13). There were significant differences in postoperative work recovery (RR=0.72,P=0.008), overall quality of life (WMD=-12.06,P0.01), weight gain (WMD=-4.16,P0.01) and operative time (WMD=101.53,P0.01). The DPPHR group is better than the PPPD/PD group. Conclusion: DPPHR and PPPD/PD are equally safe and effective in perioperative mortality, postoperative pain relief, postoperative pancreatic dysfunction, and total postoperative complications. However, DPPHR is safe and effective in the time of operation and weight gain after operation. The recovery of work after operation is superior to that of PPPD/PD, which can improve the overall quality of life of the patients.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R657.51
本文編號：2371925
[Abstract]:Objective: to analyze the relationship between pancreaticoduodenectomy (pylorus-preserving pancreatoduodenectomy,PPPD/pancreatoduodenectomy,PD) and duodenal preserving pancreatectomy (duodenum-preserving pancreatic head resection,) by Meta analysis. To evaluate the safety and efficacy of DPPHR in the treatment of chronic pancreatitis. Methods: a randomized controlled trial (randomized controlled trial,RCT) of PPPD/PD and DPPHR in the treatment of chronic pancreatitis was systematically searched on Pubmed,EMbase,Springer-Link,The Cochrane Library. The risk of bias was evaluated according to Cochrane Handbook 5.1. The data of perioperative mortality, postoperative pain relief, pancreatic dysfunction, exocrine dysfunction and overall quality of life were analyzed with Rev Man 5.3. Results: there were 7 randomized controlled trials in which 366 patients were included in the analysis. Pain relief (RR=0.92,P=0.26), perioperative mortality (RR=0.75,P=0.45), postoperative pain relief (RR=0.92,P=0.26) and perioperative mortality (RR=0.75,P=0.45) in the PPPD/PD group were compared with those in the DPPHR group. Postoperative pancreatic endocrine dysfunction (RR=1.30,P=0.15), postoperative pancreatic exocrine dysfunction (RR=2.43,P=0.10), total postoperative complications (RR=1.70,) There was no significant difference in P0. 13). There were significant differences in postoperative work recovery (RR=0.72,P=0.008), overall quality of life (WMD=-12.06,P0.01), weight gain (WMD=-4.16,P0.01) and operative time (WMD=101.53,P0.01). The DPPHR group is better than the PPPD/PD group. Conclusion: DPPHR and PPPD/PD are equally safe and effective in perioperative mortality, postoperative pain relief, postoperative pancreatic dysfunction, and total postoperative complications. However, DPPHR is safe and effective in the time of operation and weight gain after operation. The recovery of work after operation is superior to that of PPPD/PD, which can improve the overall quality of life of the patients.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R657.51
【參考文獻】
相關(guān)期刊論文 前1條
1 苗毅;陳建敏;;胰頭部腫塊的病理學(xué)依據(jù)與手術(shù)決策[J];中國實用外科雜志;2009年08期
，本文編號：2371925
本文鏈接：http://sikaile.net/yixuelunwen/waikelunwen/2371925.html
最近更新
教材專著
