本文選題：食管癌 + 吻合口瘺�。� 參考：《河南科技大學(xué)》2015年碩士論文

【摘要】：目的:對食管癌術(shù)后吻合口瘺發(fā)生的危險因素進(jìn)行系統(tǒng)評價,進(jìn)一步探討吻合口瘺發(fā)生的相關(guān)因素,對于有效預(yù)防并降低吻合口瘺的發(fā)生率具有重要意義。方法:納入分析食管癌(食道癌)術(shù)后吻合口瘺(漏)的危險因素的臨床研究。通過以下電子檢索數(shù)據(jù)庫Cochrane圖書館、MEDLINE(1993~2014.07)、EMBASE(1993~2014.07)、中國生物醫(yī)學(xué)文獻(xiàn)光盤數(shù)據(jù)庫(1993~2014.07)、中文學(xué)術(shù)期刊全文數(shù)據(jù)庫(1993~2014.07)、中文科技期刊全文數(shù)據(jù)庫(1993~2014.07),中文生物醫(yī)學(xué)期刊數(shù)據(jù)庫(1993~2014.07)、萬方數(shù)據(jù)庫。對臨床研究進(jìn)行質(zhì)量評估后,應(yīng)用Cochrane協(xié)作網(wǎng)提供的Review Manger5.0軟件包對其危險因素進(jìn)行分析,計算比值比(Odds Ratio,OR)。結(jié)果:據(jù)納入及排除標(biāo)準(zhǔn),經(jīng)篩選后納入Meta-分析的文獻(xiàn)24篇。男性食管癌患者吻合口瘺的發(fā)生率高于女性但不具有統(tǒng)計學(xué)意義,(P=0.05)合并OR值為0.73(95%CI:0.54~1.00);年齡≥60歲的食管癌患者吻合口瘺的發(fā)生率高于60歲以下患者,但不具有統(tǒng)計學(xué)意義,(P0.05),合并OR值為0.79(95%CI:0.56~1.10)⺄術(shù)前患有糖尿病的食管癌患者吻合口瘺發(fā)生率高于非糖尿病者,合并OR值為2.40(95%CI:1.64~3.52,P0.01)⺄術(shù)前血清白蛋白≥35g/L的食管癌患者吻合口瘺發(fā)生率低于35g/L者,合并OR值為15.06(95%CI:9.82~23.10,P0.01);術(shù)前合并呼吸系統(tǒng)疾病的食管癌患者吻合口瘺發(fā)生率高于無呼吸系統(tǒng)疾病者,合并OR值為10.04(95%CI:6.92~14.58,P0.01);術(shù)前患有高血壓病的食管癌患者吻合口瘺發(fā)生率高于非高血壓病者,合并OR值為2.40(95%CI:1.64~3.52,P0.01);術(shù)前行新輔助放療的食管癌患者吻合口瘺的發(fā)生率高于未接受新輔助放療者,合并OR值為7.21(95%CI:3.20~16.20,P0.01);食管癌分期Ⅰ、Ⅱ的食管癌患者吻合口瘺發(fā)生率低于Ⅲ、Ⅳ期患者,合并OR值為0.23(95%CI:0.16~0.33,P0.01);手術(shù)時間4.5h的食管癌患者吻合口瘺的發(fā)生率低于手術(shù)時間≥4.5h者,合并OR值為0.25(95%CI:0.16~0.37,P0.01);手工吻合的食管癌患者吻合口瘺發(fā)生率高于吻合器吻合者,合并OR值為0.61(95%CI:0.43~0.86,P0.01);經(jīng)胸骨后頸部吻合的食管癌患者吻合口瘺發(fā)生率高于經(jīng)食管床頸部吻合者,合并OR值為3.20(95%CI:2.41~4.25,P0.01)。結(jié)論:初步確定糖尿病、術(shù)前血清白蛋白35g/L、呼吸系統(tǒng)疾病、高血壓病、術(shù)前新輔助放療、食管癌Ⅲ、Ⅳ期、手術(shù)時間≥4.5h、手工吻合、經(jīng)胸骨后頸部吻合是食管癌術(shù)后吻合口瘺的危險因素。
[Abstract]:Objective: to evaluate the risk factors of anastomotic fistula after esophageal cancer operation, and to further explore the related factors of anastomotic fistula, which is of great significance to effectively prevent and reduce the incidence of anastomotic fistula. Methods: to analyze the risk factors of anastomotic leakage after esophageal carcinoma operation. Through the following electronic retrieval database, Cochrane Library, Cochrane Library, Cochrane Library, China Biomedical Literature CD-ROM database, Chinese academic journal full text database, Chinese Science and Technology Journal Full-text Database, Chinese Biomedical Journals Database, Chinese Biomedical Journal Database, 1993 / 3 / 2014 / 07, Chinese Biomedical Journal Database, China Biomedical Journals Database No., 1993 / 04 / 07, Chinese Biomedical Journal Database, China Biomedical Journal Database, 1993,2014.07, Chinese Biomedical Journal Database No., 1993 / 04 / 07, Chinese Biomedical Journal Database, China Biomedical Journals Database, Chinese Biomedical Journals Database. After the quality evaluation of clinical research, the risk factors were analyzed by Review Manger5.0 software package provided by Cochrane cooperation network, and the ratio of odds ratio was calculated. Results: according to inclusion and exclusion criteria, 24 articles were selected and included in Meta-analysis. The incidence of anastomotic fistula in male patients with esophageal cancer was higher than that in women but not statistically significant (OR = 0.7395 CI: 0.541.00), and the incidence of anastomotic fistula in patients with esophageal cancer 鈮，

本文編號：1888701