胆囊切除术后并胆总管结石的循证治疗  

Evidence-based Treatment for Post-cholecystectomy CBDS

作　　者：谭小平[1] 朱燕妮[1] 张庆[1] 何长华[1] 

机构地区：[1]长江大学附属第一人民医院消化内科,湖北省荆州市434000

出　　处：《中国全科医学》2013年第6期657-659,共3页Chinese General Practice

摘　　要：目的借助循证医学的方法为1例胆囊切除术后并胆总管结石的患者确定治疗目标及治疗方案。方法在充分评估患者情况后,根据PICO原则,提出临床问题,从Cochrane图书馆(网络版)、MEDLINE(PubMed,1980—2010年)、EMBase网站(1990—2010年)等数据库查找与胆囊切除术后并胆总管结石相关的系统评价或Meta分析文章及随机对照试验,对相关证据进行评价后制定治疗方案。结果共检索出与不同问题相关的随机对照试验118篇,系统评价或Meta分析文章21篇。通过对检索结果进行分析,为患者制定了以内镜微创治疗为主的治疗方案。经半年随访证实该方案适合本例患者。结论采用循证医学的方法为胆囊切除术后并胆总管结石患者制定合理的治疗方案,可有效提高治疗效果,提高患者生存质量。Objective To make an individualized treatment plan for a patient with post - cholecystectomy CBDS by u- sing evidence - based medicine. Methods According to PICO principles, clinical questions were proposed after adequate assess- ment of the patient＇s condition. Systematic reviews and randomized controlled trials were collected from Cochrane library （ 1990-- 2010）, MEDLINE （PubMed, 1980--2010） and EMBase （1990--2010） . The treatment plan was established after evaluating relevant evidences. Results A total of 118 RCTs and 21 systematic reviews or Meta analyses were retrieved. A plan of endoscopic minimally invasive treatment was established after analyzing the retrieved results. The six - month follow up proved the treatment suitable for the patient. Conclusion The treatment efficacy for post - cholecysteetomy CBDS patient can be improved by establis- hing an individualized treatment plan according to evidence -based methods.

关 键 词：胆囊切除术 胆总管结石 循证医学 治疗 

分 类 号：R657.42[医药卫生—外科学]