单孔和传统腹腔镜阑尾切除术疗效对比的Meta分析  

Comparison of Treatment Effects Between the Single-Port and Conventional Laparoscopic Appendectomy:Meta-Analysis

作　　者：郭涛[1] 刘权焰[1] 李婷[1] 

机构地区：[1]武汉大学中南医院普外科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2014年第5期816-820,共5页Medical Journal of Wuhan University

摘　　要：目的:用Meta分析的方法比较单孔腹腔镜与传统腹腔镜在阑尾炎手术中的治疗效果。方法:检索中国知网数据库、万方数据库、Cochrane数据库、Pubmed数据库。检索时限均为2009年1月-2014年1月。并人工检索相关文献,查找与单孔腹腔镜及传统腹腔镜有关的临床随机对照研究。采用RevMAN 5.0软件对各文献中研究所提供的手术时间、术中出血量、住院时间这3个指标进行综合定量评价。结果:最终有12篇文献纳入,总样本量患者数为1 251人,其中单孔腹腔镜组为631人,传统腹腔镜组为620人。Meta分析显示:单孔腹腔镜组与传统腹腔镜组在手术时间(WMD=2.78,95%CI[-3.23,8.78],P=0.36)和住院时间(WMD=-0.22,95%CI[-0.45,0.01],P=0.06)这两项指标无统计学差异。而术中出血量单孔腹腔镜组较传统腹腔镜组明显增多(WMD=0.49,95%CI[0.35,0.63],P<0.000 01)。结论:在急、慢性阑尾炎手术治疗中,传统腹腔镜手术在疗效上优于单孔腹腔镜手术,但单孔腹腔镜手术可以减少腹壁损伤,更加美观。因此,在具体实施手术时可酌情选择。Objective：To compare the treatment effects by a Meta-analysis of single-port laparoscopic and conventional laparoscopic appendectomy.Methods：Chinese Journal Full Text Database（CNKI）,Wanfang Data Resource System,Cochrane database and PubMed database were searched by computer and related magazines were retrieved manually for finding the randomized controlled trails of single-port laparoscopic appendectomy and conventional laparoscopic appendectomy.Published time is set from January 2009 to January 2014.RevMan5.0software was used to make quantitative analysis of operation time,the amount of bleeding and length of hospital stay.Results：Twelve clinical controlled studies were included in this research.A total sample size involved 1 251 patients,including 631 cases in single-port group and 620 cases in conventional group.Meta-analysis showed that the difference of the amount of bleeding（WMD=0.49,95%CI[0.35,0.63],P〈0.000 01）was statistically significant.But the differences of the operation time（WMD=2.78,95%CI[-3.23,8.78],P=0.36）and length of hospital stay（WMD=-0.22,95%CI[-0.45,0.01],P=0.06）showed no statistical significance.Conclusion：The treatment effect of conventional laparoscopic appendectomy is better than that of single-port laparoscopic appen-dectomy.But single-port laparoscopic appendectomy would reduce the injury of the belly wall and it was closer to scarless according to purpose of minimally invasive operation.So we can choose either of them according to the specific situation.

关 键 词：单孔腹腔镜 传统腹腔镜 阑尾炎手术 META分析 

分 类 号：R656.8[医药卫生—外科学]