腹腔镜幽门环肌切开术与开腹手术治疗先天性肥厚性幽门狭窄有效性和安全性Meta分析  

Efficacy and safety of laparoscopic pyloromyotomy and open pyloromyotomy for the treatment of congenital hypertrophic pyloric stenosis：Meta analysis

作　　者：李万福[1] 马柱[1] 李朝旺[1] 卡德尔江[1] 

机构地区：[1]新疆医科大学第一附属医院小儿外科,乌鲁木齐830054

出　　处：《中华实用儿科临床杂志》2013年第18期1433-1436,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：乌鲁木齐市科技局应用开发研究项目（Y121310013）

摘　　要：目的 评价腹腔镜幽门环肌切开术与开腹手术对治疗先天性肥厚性幽门狭窄的有效性和安全性,为临床制定合理的治疗方案提供依据.方法 计算机检索Cochrane图书馆、PubMed、EMbase、CINAHL、Web of Science、中国生物医学文献数据库、中国期刊全文数据库等中外生物医学数据库.收集关于腹腔镜幽门环肌切开术与开腹手术对治疗小儿先天性肥厚性幽门狭窄的随机对照试验,按Cochrane系统评价方法评价所纳入研究的文献质量,并提取有效数据后采用RevMan5.1软件进行Meta分析.结果 纳入5项随机对照研究,共计552例患者,结果显示采用腹腔镜幽门环肌切开术术后并发症的发生率与开腹手术比较差异无统计学意义[OR=2.59,95％ CI（0.90 ～ 7.47）].与开腹手术相比,采用腹腔镜幽门环肌切开术的患者术后恢复进食的时间和术后住院时间均显著缩短（MD=-3.63,95％ CI：-5.19 ～-2.06;MD=-12.62,95％ CI：-16.13～-9.11）.结论 腹腔镜幽门环肌切开术较开腹手术创伤小,能够缩短术后禁食水时间,减少住院天数,有利于患者恢复,但2种手术的术后并发症仍值得关注.Objective To evaluate the efficacy and safety of laparoscopic pyloromyotomy （LP） or open pyloromyotomy （OP） for the treatment of congenital hypertrophic pyloric stenosis（CHPS）,and to provide a basis for reasonable treatment programme for clinic.Methods Randomized control trials （RCTs） about LP and OP for the treatment of CHPS were searched using Cochrane library,PubMed,Embase,Cumulative Index To Nursing And Allied Health Literature （CINAHL）,Web of Science,Chinese biomedical literature database and China National Knowledge Internet database.Study selection and Meta analysis were conducted according to the Cochrane Handbook for systematic reviews.Extracted data from the selected studies were reviewed by the reviewers and analyzed using RevMan 5.1 software.Results Five RCTs with a total of 552 patients fulfilled the inclusion criteria and were analyzed in this review.Meta analysis showed that there was no statistically significant differences in incidence of postoperative complications between LP and OP （OR =2.59,95 ％ CI：0.90-7.47）.Compared with OP,the postoperative recovery eating time and postoperative hospital stay in patient with LP were significantly reduced （MD =-3.63,95％ CI：-5.19--2.06） ;MD =-12.62,95 ％ CI：-16.13--9.11）.Conclusions LP result in earlier feeding,shorter hospital stay,less trauma with superior cosmetic outcome and earlier recovery of the patient than the OP.But the postoperative complication between the two surgeries still remains the topic of concern.

关 键 词：幽门环肌切开术 先天性肥厚性幽门狭窄 META分析 

分 类 号：R726.5[医药卫生—儿科]