【摘要】：目的：系統(tǒng)評價(jià)單孔腹腔鏡(SILS)與傳統(tǒng)多孔腹腔鏡脾切除術(shù)(LS)的臨床安全性及可行性。方法：計(jì)算機(jī)檢索PubMed、EMbase、MEDLINE、SCI、知網(wǎng)、萬方數(shù)據(jù)庫和The Cochrane Library,手工檢索相關(guān)期刊及會(huì)議記錄,同時(shí)追蹤相關(guān)文章參考文獻(xiàn),收集單孔與多孔腹腔鏡脾切除術(shù)的隨機(jī)或非隨機(jī)同期對照試驗(yàn),檢索時(shí)限截止至2014年10月。由兩名評價(jià)者按照納入與排除標(biāo)準(zhǔn)選擇試驗(yàn)、提取所需資料和評價(jià)文獻(xiàn)質(zhì)量后,采用Cochrane平臺推出的RevMan 5.2.5軟件進(jìn)行Meta分析。結(jié)果：本研究共納入7個(gè)非隨機(jī)對照試驗(yàn)(CCT),其中外文文獻(xiàn)4篇,中文文獻(xiàn)3篇,共202例患者。Meta分析顯示手術(shù)時(shí)間(MD=-9.69；95%CI=-74.88, 55.51；P=0.77),術(shù)中出血量(MD=-27.82；95%=-101.23,45.59；P=0.46),平均住院天數(shù)(MD=-0.47；95%CI=-2.12,1.18；P=0.58),治療費(fèi)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(jì)學(xué)差異,而術(shù)后疼痛(MD=-1.41；95%CI=-99.76,219.91；P=0.46),術(shù)后經(jīng)肛門排氣時(shí)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(shù)。結(jié)論：單孔腹腔鏡脾切除術(shù)是安全、可行的。由于納入研究數(shù)量和質(zhì)量存在局限性,上述結(jié)論仍需大樣本、高質(zhì)量RCT進(jìn)一步驗(yàn)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(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R657.6

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本文編號：2391247