發(fā)布時(shí)間：2018-09-14 08:24

【摘要】：目的系統(tǒng)評(píng)價(jià)單孔胸腔鏡與傳統(tǒng)多孔胸腔鏡手術(shù)治療肺癌的臨床療效。方法計(jì)算機(jī)檢索Pub Med、The Cochrane Library(2016年3期)、EMbase、CBM、CNK和Wan Fang Data數(shù)據(jù)庫(kù),搜集單孔胸腔鏡與傳統(tǒng)多孔胸腔鏡手術(shù)治療肺癌的隨機(jī)對(duì)照試驗(yàn)和隊(duì)列研究,檢索時(shí)限均為建庫(kù)至2016年4月。由2位研究員獨(dú)立篩選文獻(xiàn)、提取資料和評(píng)價(jià)納入研究的偏倚風(fēng)險(xiǎn)后,采用Rev Man 5.3軟件進(jìn)行Meta分析。結(jié)果共納入9個(gè)隊(duì)列研究,1 318例患者。Meta分析結(jié)果顯示:與傳統(tǒng)多孔胸腔鏡手術(shù)相比,單孔胸腔鏡手術(shù)治療肺癌胸腔引流時(shí)間更短[MD= 0.70,95%CI( 1.38, 0.02),P=0.04],住院時(shí)間更短[MD= 0.52,95%CI( 0.91, 0.14),P=0.007],術(shù)中出血量更少[MD= 18.49,95%CI( 33.61, 3.37),P=0.02],術(shù)后第1、3天疼痛評(píng)分更低[1天:MD= 0.32,95%CI( 0.51, 0.14),P=0.000 7;3天:MD= 0.48,95%CI( 0.58, 0.38),P0.000 01]。但兩組在手術(shù)時(shí)間[MD= 3.40,95%CI( 13.65,6.85),P=0.52]、術(shù)后并發(fā)癥發(fā)生率[OR=0.91,95%CI(0.65,1.27),P=0.56]、淋巴結(jié)清掃個(gè)數(shù)[MD= 0.79,95%CI( 2.35,0.77),P=0.32]、住院總費(fèi)用[MD=0.47,95%CI( 0.39,1.32),P=0.28]、術(shù)中中轉(zhuǎn)率[OR=0.92,95%CI(0.44,1.93),P=0.82]及術(shù)后第7天疼痛評(píng)分[MD= 1.18,95%CI( 2.42,0.07),P=0.06]方面,差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論單孔胸腔鏡手術(shù)治療肺癌比傳統(tǒng)多孔胸腔鏡手術(shù)在減輕手術(shù)創(chuàng)傷方面有一定優(yōu)勢(shì),且手術(shù)安全性較好。受納入研究數(shù)量和質(zhì)量的限制,上述結(jié)論仍需開(kāi)展更多大樣本、多中心、長(zhǎng)期隨訪的研究來(lái)進(jìn)行驗(yàn)證。
[Abstract]:Objective to evaluate the clinical effect of single-hole thoracoscopy and traditional multi-hole thoracoscopy in the treatment of lung cancer. Methods the database of Pub Med,The Cochrane Library (2016 (3rd issue) was searched by computer. The randomized controlled trial and cohort study of single hole thoracoscopy and traditional porous thoracoscopic surgery for lung cancer were collected. The retrieval time was established until April 2016. Two researchers independently sifted the literature, extracted the data and evaluated the bias risk in the study, and then used Rev Man 5.3 software to carry out Meta analysis. Results A total of 1 318 patients were included in 9 cohorts. Meta-analysis showed that compared with traditional thoracoscopic surgery, 鍗曞瓟鑳歌厰闀滄墜鏈不鐤楄偤鐧岃兏鑵斿紩嫻佹椂闂存洿鐭璠MD= 0.70,95%CI( 1.38, 0.02),P=0.04],浣忛櫌鏃墮棿鏇寸煭[MD= 0.52,95%CI( 0.91, 0.14),P=0.007],鏈腑鍑?guó)櫋�閲忔洿灝慬MD= 18.49,95%CI( 33.61, 3.37),P=0.02],鏈悗絎，

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