腹腔镜阑尾切除术安全性的Meta分析  

A META-ANALYSIS OF THE SAFETY OF LAPAROSCOPIC APPENDECTOMY

作　　者：段立纪[1] 王存川[1] 陈鋆[1] 

机构地区：[1]暨南大学医学院第一附属医院腹腔镜外科,广州510630

出　　处：《中国内镜杂志》2001年第6期18-20,共3页China Journal of Endoscopy

摘　　要：目的 :目前临床上对于腹腔镜阑尾切除术的安全性仍存在很大争议 ,故设计了这个Meta分析 ,以得出一个定性又定量的结果 ,指导临床治疗方案的选择。方法 :在Medline中广泛检索有关文献 ,整理原始文献并摘录有关数据 ,用固定效应模型对之进行ORi的检验、合并。数据运算通过SPSS8.0统计软件包完成。结果 :共有 14篇文献满足纳入标准。与开腹阑尾切除术相比 ,腹腔镜阑尾切除术伤口感染率较低 ,但两者在总并发症及腹内脓肿发生率方面没有统计学意义上的不同。结论 :腹腔镜阑尾切除术是安全。Objective:Although a series of randomized controlled trials (RCTs) comparing of laparoscopic appendectomy(LA) with open appendectomy (OA) have been conducted recently,the role of laparoscopic surgery in the management of patients with acute appendicitis is still controversial.This paper aims to determine whether LA would reduce wound infection and overall complication in patients with acute appendicitis. Method:A meta-analysis was designed to review systematically the results of published RCTs comparing LA with OA.An extensive literature search was conducted for appropriate articles(1992～2001) through MEDLINE or hand search cross-referencing bibliographies of reviewed articles and meeting abstracts.Data of RCTs were extracted and analysised according to predefined criteria.The statistical package for the social science 8.0 was used to calculated odds ratios (ORs) and 95% confidence intervals (95%CI).The fix-effected model and the random-effected model were used for statistical analysis. Results:Fourteen studies which meeting the inclusion criteria were identified,two of which reported results lacking of the overall complication.In this meta-analysis,there are fewer wound infection in LA(ORs:0.39,95% CI:0.23～0.65),but no significant difference in overall complications (ORs:1.07,95% CI:0.79～1.65)and intrenomial-absess(ORs:1.31,95% CI:0.57～3.00)comparing with OA. Conclusions:This meta-analysis suggests that laparoscopic appendectomy was associated with a reduced risk of wound infection,with no increase in other complication.So laparoscopic appendectomy is safe and effective,but future RCTs should be blind to minimized bias.

关 键 词：腹腔镜 阑尾切除术 META分析 

分 类 号：R656.8[医药卫生—外科学]