胃十二指腸術后胃癱綜合征相關危險因素的Meta分析
發(fā)布時間：2018-12-26 11:29
【摘要】：目的:采用Meta分析對胃十二指腸術后胃癱綜合征(Postoperative gastroparesis syndrome,PGS)的危險因素及其關聯(lián)強度進行綜合評價,為降低術后胃癱綜合征的發(fā)生率提供循證依據(jù)。方法:檢索國內(nèi)自2006年6月至2016年6月期間公開發(fā)表的有關胃癱綜合征危險因素的19篇文獻資料,采用Cochrane協(xié)作網(wǎng)提供的Rev Man5.2分析軟件對所提取資料依次進行異質性檢驗,根據(jù)其結果選擇不同的模型對各個危險因素進行Meta分析。評價12種危險因素與胃癱綜合征的關聯(lián)性,采用比值比(OR)及其95%可信區(qū)間(95%CI)來表示。結果:1.性別:進行Meta分析的15篇文獻的合并OR值為0.95,95%CI為0.78~1.15。表明男性患者的PGS發(fā)生率與女性患者的PGS發(fā)生率沒有統(tǒng)計學意義(P0.05)。2.年齡:進行Meta分析的8篇文獻的合并OR值為10.75,95%CI為9.49~12.00,表明患者進行手術時年齡小的PGS發(fā)生率低于年齡大的(P0.05)。3.術前存在幽門梗阻:進行Meta分析的14篇文獻的合并OR值為3.66,95%CI為2.95~4.54,表明術前不存在幽門梗阻的PGS發(fā)生率低于術前存在幽門梗阻(P0.05)。4.術前合并焦慮等精神心理:進行Meta分析的9篇文獻的合并OR值為2.93,95%CI為2.25~3.80,表明術前不具有焦慮的精神心理因素的PGS發(fā)生率低于術前合并焦慮的精神心理因素(P0.05)。5.手術吻合方式:進行Meta分析的16篇文獻的合并OR值為為0.24,95%CI為0.19~0.30,表明行Billroth II手術吻合的PGS發(fā)生率高于Billroth I手術吻合(P0.05)。6.術后使用鎮(zhèn)痛泵:進行Meta分析的11篇文獻的合并OR值為2.47,95%CI為1.94~3.15,表明術后不使用自控鎮(zhèn)痛泵的PGS發(fā)生率低于術后使用自控鎮(zhèn)痛泵(P0.05)。7.圍手術期低蛋白血癥:進行Meta分析的9篇文獻的合并OR值為2.61,95%CI為2.00~3.42,表明行術前白蛋白水平小于30g/L的PGS發(fā)生率高于術前白蛋白水平≥30g/L患者(P0.05)。8.手術時機:進行Meta分析的8篇文獻的合并OR值為1.86,95%CI為1.33~2.60,表明行急診手術的PGS發(fā)生率高于非急診手術(P0.05)。9.手術時間:進行Meta分析的5篇文獻的合并OR值為0.75,95%CI為0.65~0.84,表明手術時間長的PGS發(fā)生率高于手術時間短的,(P0.05)。10.手術中出血量:進行Meta分析的6篇文獻的合并OR值為84.39,95%CI為80.83~87.94,表表明術中出血量多的PGS發(fā)生率高于術中出血量少的(P0.05)。11.手術方式:進行Meta分析的4篇文獻的合并OR值為0.46,95%CI為0.30~0.73,表明開腹手術的PGS發(fā)生率高于腹腔鏡手術(P0.05)。12.術后高血糖:進行Meta分析的5篇文獻的合并OR值為4.13,95%CI為2.72~6.29,表明術后合并高血糖的PGS發(fā)生率高于術后不合并高血糖的(P0.05)。結論:與術后胃癱綜合征發(fā)生相關聯(lián)的因素有術前幽門梗阻、較高的年齡、術后高血糖、較長的手術時間、急診手術、圍手術期的低蛋白血癥、手術方式、術前合并焦慮等精神心理因素、BillrothⅡ式吻合、術中較多的出血量、術后使用鎮(zhèn)痛泵。
[Abstract]:Objective: to evaluate the risk factors and associated strength of gastroparesis syndrome (Postoperative gastroparesis syndrome,PGS) after gastroduodenal surgery by Meta analysis, and to provide evidence-based evidence for reducing the incidence of postoperative gastroparesis syndrome. Methods: from June 2006 to June 2016, 19 articles of literature on the risk factors of gastroparesis syndrome were retrieved, and the heterogeneity of the extracted data was examined by Rev Man5.2 software provided by Cochrane Cooperative Network. According to the results, different models were selected to analyze the risk factors by Meta. To evaluate the correlation between 12 risk factors and gastroparesis syndrome, the ratio (OR) and its 95% confidence interval (95%CI) were used. Results: 1. Sex: the combined OR value of 15 articles for Meta analysis was 0.95 鹵0.78 CI 0.78 / 1.15. The results showed that the incidence of PGS in male patients was not significantly different from that in female patients (P0.05). Age: the combined OR value of 8 articles of Meta analysis was 10.75 鹵9595 CI = 9.491.00, which indicated that the incidence of PGS at the time of operation was lower than that of the older ones (P0.05). Preoperative pyloric obstruction: the combined OR value of 14 articles for Meta analysis was 3.66 鹵95 CI 2.95 鹵4.54, indicating that the incidence of PGS without pyloric obstruction before operation was lower than that without pyloric obstruction before operation (P0.05). Mental and psychological factors such as anxiety before operation: the combined OR value of 9 articles for Meta analysis was 2.93 鹵95 and CI was 2.25 鹵3.80, respectively. The results showed that the incidence of PGS without anxiety was lower than that with anxiety before operation (P 0.05). Operative anastomosis: the combined OR value of 16 articles with Meta analysis was 0.2495 CI 0.190.30, which indicated that the incidence of PGS with Billroth II operation anastomosis was higher than that with Billroth I operation anastomosis (P0.05). Postoperative analgesic pump: the combined OR value of 11 articles for Meta analysis was 2.47 鹵95 CI 1.94 鹵3.15, which indicated that the incidence of PGS without PCAP was lower than that of PCAP (P0.05). Perioperative hypoproteinemia: the combined OR values of 9 articles for Meta analysis were 2.61 鹵95 and CI was 2.00 鹵3.42, respectively. The incidence of PGS with preoperative albumin level less than 30g/L was higher than that of patients with preoperative albumin level 鈮，
本文編號：2392057
[Abstract]:Objective: to evaluate the risk factors and associated strength of gastroparesis syndrome (Postoperative gastroparesis syndrome,PGS) after gastroduodenal surgery by Meta analysis, and to provide evidence-based evidence for reducing the incidence of postoperative gastroparesis syndrome. Methods: from June 2006 to June 2016, 19 articles of literature on the risk factors of gastroparesis syndrome were retrieved, and the heterogeneity of the extracted data was examined by Rev Man5.2 software provided by Cochrane Cooperative Network. According to the results, different models were selected to analyze the risk factors by Meta. To evaluate the correlation between 12 risk factors and gastroparesis syndrome, the ratio (OR) and its 95% confidence interval (95%CI) were used. Results: 1. Sex: the combined OR value of 15 articles for Meta analysis was 0.95 鹵0.78 CI 0.78 / 1.15. The results showed that the incidence of PGS in male patients was not significantly different from that in female patients (P0.05). Age: the combined OR value of 8 articles of Meta analysis was 10.75 鹵9595 CI = 9.491.00, which indicated that the incidence of PGS at the time of operation was lower than that of the older ones (P0.05). Preoperative pyloric obstruction: the combined OR value of 14 articles for Meta analysis was 3.66 鹵95 CI 2.95 鹵4.54, indicating that the incidence of PGS without pyloric obstruction before operation was lower than that without pyloric obstruction before operation (P0.05). Mental and psychological factors such as anxiety before operation: the combined OR value of 9 articles for Meta analysis was 2.93 鹵95 and CI was 2.25 鹵3.80, respectively. The results showed that the incidence of PGS without anxiety was lower than that with anxiety before operation (P 0.05). Operative anastomosis: the combined OR value of 16 articles with Meta analysis was 0.2495 CI 0.190.30, which indicated that the incidence of PGS with Billroth II operation anastomosis was higher than that with Billroth I operation anastomosis (P0.05). Postoperative analgesic pump: the combined OR value of 11 articles for Meta analysis was 2.47 鹵95 CI 1.94 鹵3.15, which indicated that the incidence of PGS without PCAP was lower than that of PCAP (P0.05). Perioperative hypoproteinemia: the combined OR values of 9 articles for Meta analysis were 2.61 鹵95 and CI was 2.00 鹵3.42, respectively. The incidence of PGS with preoperative albumin level less than 30g/L was higher than that of patients with preoperative albumin level 鈮，
本文編號：2392057
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