超声刀与电刀在乳腺癌手术中应用效果比较的Meta分析  

Ultrasonic scalpel versus electrocautery in breast cancer surgery: a Meta-analysis

作　　者：李孟天 刘刚[1] 郁晓峰[1] 孙旭凌[2] 黄桂林[2] 

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]石河子大学医学院第一附属医院普外二科,新疆石河子832000

出　　处：《中国普通外科杂志》2015年第11期1541-1546,共6页China Journal of General Surgery

摘　　要：目的:比较超声刀与传统电刀用于乳腺癌术中乳房组织切除、腋窝淋巴结清扫的疗效。方法:检索国内外数据库,收集相关随机对照试验(RCT),行文献筛选、质量评价和资料提取后,应用RevMan 5.2软件完成Meta分析。结果:共纳入8个RCT,总样本量604例,其中超声刀组300例,电刀组304例。Meta分析结果显示,与电刀组比较,超声刀组手术时间无明显差异(WMD=6.20,95%CI=-5.02~17.41,P=0.28),但术中出血量(WMD=-61.42,95%CI=-83.76^-39.09)、术后引流量(WMD=-374.92,95%CI=-453.90^-295.95)、引流时间(WMD=-3.30,95%CI=-5.10^-1.49)、术后皮下积液发生率(RR=0.51,95%CI=0.38~0.68)均明显降低(均P<0.05)。结论:乳腺癌手术中,使用超声刀在控制术中出血量、减少术后引流、降低术后皮下积液方面优于电刀。Objective：To compare the efficacy of ultrasonic scalpel and traditional electrocautery for mastectomy and axillary lymph node dissection in breast cancer surgery.Methods：The relevant randomized controlled trials（RTCs） were collected by searching the national and international databases.After literature screening,quality assessment and data extraction,Meta-analysis was performed by using RevMan 5.2 software.Results：Eight RTCs were finally included,with a total sample size of 604 cases comprising 300 cases in ultrasonic scalpel group and 304 cases in electrocautery group.Results of Meta-analysis showed that in ultrasonic scalpel group compared with electrocautery group,the operative time had no significant difference（WMD=6.20,95%CI=-5.02-17.41,P=0.28）,but the intraoperative blood loss（WMD=-61.42,95%CI=-83.76—39.09）,postoperative drainage volume（WMD=-374.92,95%CI=-453.90—295.95）,drainage time（WMD=-3.30,95%CI=-5.10—1.49）,and the incidence of subcutaneous fluid collection（RR=0.51,95%CI=0.38-0.68） were all significantly decreased（all P〈0.05）.Conclusion：In breast cancer surgery,use of ultrasonic scalpel is superior to that of electrocautery in respects of intraoperative bleeding control,and reducing postoperative drainage and incidence of subcutaneous fluid collection.

关 键 词：乳腺肿瘤 乳房切除术 超声外科手术 电凝术 

分 类 号：R737.9[医药卫生—肿瘤]