【摘要】：目的:對比評價ALPPS和經(jīng)皮門靜脈栓塞活動兩步肝切除術(shù)的有效性、安全性。方法:計算機檢索數(shù)據(jù)庫Pubmed、Embase、Corchrane library、CNKI有關(guān)ALPPS與經(jīng)皮門靜脈栓塞后兩步肝切除術(shù)的臨床對比研究。篩選文獻,提取數(shù)據(jù),二分類變量采用比值比(OR)為效應(yīng)量進行Meta分析,連續(xù)性變量采用均數(shù)標(biāo)準(zhǔn)差(SMD)進行Meta分析,使用Revman5.3進行meta分析。結(jié)果:共納入6篇臨床對比研究文獻,包含ALPPS組78人,PVE組316人。兩步手術(shù)完成率為:ALPPS 100%;PVE 84.5%(OR:7.85,95%CI1.89-32.6,Z=2.83,P=0.005)。殘肝體積增長率:ALPPS 59%;PVE46.5%(MD=19.45,95%CI,5.19-33.71,Z=2.67,p=0.008)。總體住院時間:ALPPS組10.7天,PVE組29.3天(Z=5.05,MD=-19.5,95%CI,-22.44—11.67,P0.000001)。并發(fā)癥發(fā)生率:ALPPS組42.6%,PVE組39.6%(OR:1.15,95%CI 0.68-1.94,Z=0.53,P=0.6)。病死率:ALPPS組6%,PVE組4%(OR=2.0,95%CI,0.69-5.81,P=0.21)。結(jié)論:ALPPS對殘肝體積增生有明顯幫助,較PVE組其并發(fā)癥、病死率的發(fā)生無明顯統(tǒng)計學(xué)差異。
[Abstract]:Objective: to evaluate the efficacy and safety of ALPPS and two-step hepatectomy with percutaneous portal vein embolization. Methods: Pubmed,Embase,Corchrane library,CNKI database was searched by computer for clinical comparison of ALPPS and two-step hepatectomy after percutaneous portal vein embolization. The two classification variables were analyzed by Meta with the ratio (OR) as the effect quantity, the continuous variables with the mean standard deviation (SMD) for the Meta analysis, and the Revman5.3 with the meta analysis. Results: a total of 6 clinical comparative studies were included, including 78 patients in ALPPS group and 316 in PVE group. The complete rate of two-step operation was 84.5% (OR:7.85,95%CI1.89-32.6,Z=2.83,P=0.005). The growth rate of residual liver volume: ALPPS 59% PVE 46.5% (MD=19.45,95%CI,5.19-33.71,Z=2.67,p=0.008). The total hospitalization time was 10.7 days in ALPPS group and 29.3 days in PVE group. The incidence of complications was 42.6% in ALPPS group and 39.6% in PVE group (OR:1.15,95%CI 0.68-1.94). Mortality: 4% (OR=2.0,95%CI,0.69-5.81,P=0.21) in ALPPS group. Conclusion: ALPPS has significant effect on residual liver volume hyperplasia, and there is no significant difference in complication and mortality between PVE group and PVE group.
【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】：2016
【分類號】：R657.3

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