發(fā)布時間：2018-12-25 14:20

【摘要】：目的：系統(tǒng)評價單孔腹腔鏡(SILS)與傳統(tǒng)多孔腹腔鏡脾切除術(LS)的臨床安全性及可行性。方法：計算機檢索PubMed、EMbase、MEDLINE、SCI、知網、萬方數據庫和The Cochrane Library,手工檢索相關期刊及會議記錄,同時追蹤相關文章參考文獻,收集單孔與多孔腹腔鏡脾切除術的隨機或非隨機同期對照試驗,檢索時限截止至2014年10月。由兩名評價者按照納入與排除標準選擇試驗、提取所需資料和評價文獻質量后,采用Cochrane平臺推出的RevMan 5.2.5軟件進行Meta分析。結果：本研究共納入7個非隨機對照試驗(CCT),其中外文文獻4篇,中文文獻3篇,共202例患者。Meta分析顯示手術時間(MD=-9.69；95%CI=-74.88, 55.51；P=0.77),術中出血量(MD=-27.82；95%=-101.23,45.59；P=0.46),平均住院天數(MD=-0.47；95%CI=-2.12,1.18；P=0.58),治療費用(MD=-0.14；95%CI=-0.42,0.14；P=0.33),脾臟大小(MD=60.07；95%CI=-0.42,0.14；P=0.33)在兩組間均無統(tǒng)計學差異,而術后疼痛(MD=-1.41；95%CI=-99.76,219.91；P=0.46),術后經肛門排氣時間(MD=-0.47；95%CI=-0.84,0.10；P=0.01)均優(yōu)于多孔腹腔鏡脾切除術。結論：單孔腹腔鏡脾切除術是安全、可行的。由于納入研究數量和質量存在局限性,上述結論仍需大樣本、高質量RCT進一步驗證。
[Abstract]:Objective: to evaluate the clinical safety and feasibility of single-hole laparoscopic (SILS) and traditional porous laparoscopic splenectomy (LS). Methods: PubMed,EMbase,MEDLINE,SCI, Wanfang database and The Cochrane Library, were searched by computer for related journals and meeting records, and related articles were followed up. A randomized or non-randomized controlled trial of single hole and porous laparoscopic splenectomy was collected and the search time was up to October 2014. According to the criteria of inclusion and exclusion, the two evaluators selected the test, extracted the needed data and evaluated the quality of the literature, and then analyzed Meta with RevMan 5.2.5 software developed by Cochrane platform. Results: a total of 7 non-randomized controlled trial (CCT), were included in this study, including 4 foreign literature and 3 Chinese literatures. The Meta analysis showed the operative time (MD=-9.69;95%CI=-74.88, 55.51). P0. 77), intraoperative bleeding (MD=-27.82;95%=-101.23,45.59;P=0.46), average length of stay (MD=-0.47;95%CI=-2.12,1.18;P=0.58), treatment cost (MD=-0.14;) There was no significant difference in spleen size (MD=60.07;95%CI=-0.42,0.14;P=0.33) between the two groups, but there was postoperative pain (MD=-1.41;95%CI=-99.76219.91;). The postoperative transanal exhaust time (MD=-0.47;95%CI=-0.84,0.10;P=0.01) was better than that of porous laparoscopic splenectomy. Conclusion: single-hole laparoscopic splenectomy is safe and feasible. Due to the limitation of the quantity and quality of the study, these conclusions still need a large sample, which is further verified by high quality RCT.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R657.6

【參考文獻】

相關期刊論文 前2條

1 田銀生;李毅;張偉;李敏;劉勇;朱宇;葛明剛;;普通器械在單孔腹腔鏡手術中的應用體會[J];西部醫(yī)學;2011年10期

2 麻忠武;陳峰;徐邁宇;金肖丹;;經臍單孔與三孔法腹腔鏡膽囊、闌尾聯合切除的對比研究[J];中國微創(chuàng)外科雜志;2014年10期

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本文編號：2391247