甲状腺全切除术治疗多发结节性甲状腺肿的Meta分析  

Meta-analysis of total thyroidectomy for multinodular goiter

作　　者：曹宏泰[1,2] 韩继祥[1,2] 张冬红 俞泽元[1,2] 王满才 焦作义[1,2] 

机构地区：[1]兰州大学第二医院普外科,兰州730030 [2]甘肃省消化系肿瘤重点实验室,兰州730030

出　　处：《中南大学学报（医学版）》2014年第6期625-631,共7页Journal of Central South University ：Medical Science

基　　金：兰州大学"中央高校基本科研业务费专项基金"(lzujbky-2009-104)~~

摘　　要：目的:系统评价甲状腺全切除术(包含近全切除术)对比次全切除术治疗多发结节性甲状腺肿的疗效和安全性.方法:计算机检索Cochrane Library、PubMed、Embase、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库等,检索时间截止2013年11月.纳入甲状腺全切除术(包含近全切除术)对比次全切除术治疗多发结节性甲状腺肿的随机对照试验,由两名研究员分别独立提取数据进行文献质量评价,并用RevMan5.1软件进行Meta分析.结果:最终纳入符合标准的相关文献7篇,共2 192例患者.Meta分析结果显示:与甲状腺次全切相比,全切除术(包含近全切除术)后结节复发率低(OR=0.13,95％ CI:0.07～0.22,P＜0.001),短暂性甲状旁腺功能减低发生率较高(OR=2.33,95％ CI:1.72～3.17,P＜0.001),而在永久性喉返神经麻痹(OR=0.81,95％ CI:0.24～2.74,P=0.74)及永久性甲状旁腺功能减低(OR=2.94,95％ CI:0.48～18.11,P=0.24)方面二者之间差异无统计学意义.结论:与甲状腺次全切除术相比,全切除术(包含近全切除术)治疗多发结节性甲状腺肿的术后结节复发率明显降低,并未增加永久性并发症.Objective: To systematically evaluate the efficiency and safety of total thyroidetomy(including near-total tyhroidectomy) versus subtotal thyroidectomy for multinodular goiter. Methods: The literatures were searched from Cochrane Library, PubMed, Embase, Chinese Biological Medical Datebase, Chinese National Knowledge Infrastructure, and Chinese Science and Technology Journal Full-text Database as of November 2013. We included all randomizad controlled trials on total(including near-total) versus subtotal thyroidectomy in the treatment of multinodular goiter. The collecting of data and quality assessment were respectively completed by 2 researchers. RevMan5.1 software was used for Meta-analysis.Results: We collected 7 literatures conforming to the standard, incuding 2 192 patients. The Metaanalysis outcomes showed that total thyroidectomy was associated with lower nodule recurrence rate(OR=0.13, 95% CI: 0.07-0.22, P<0.001) and higher in transient hypoparathyroidism rate(OR=2.33, 95% CI: 1.72-3.17, P<0.001). However, no statistical difference was seen comparing total and subtotal thyroidectomy in permanent recurrent laryngeal nerve paralysis rate(OR= 0.81, 95% CI: 0.24-2.74, P=0.74) and permanent hypoparathyroidism rate(OR=2.94, 95% CI: 0.48-18.11, P=0.24).Conclusion: Nodule recurrence rate of total thyroidectomy for multinodular goiter is lower than subtotal thyroidectomy and does not increase permanent complications.

关 键 词：甲状腺全切除术 甲状腺次全切除术 多发结节性甲状腺肿 META分析 

分 类 号：R653[医药卫生—外科学]