影像引导下穿刺硬化术与腹腔镜下开窗引流术治疗非寄生虫性肝囊肿:Meta分析  

Comparison of sclerotherapy under imaging guidance versus laparoscopic fenestration for treatment of non-parasitic hepatic cysts:Meta-analysis

作　　者：李甜甜[1] 白亮亮 周乃春 李建生[1] LI Tiantian;BAI Liangliang;ZHOU Naichun;LI Jiansheng(Department of Gastroenterology;Department of Interventional Radiology;Department of Urology,the First Affiliated Hospital ofZhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化科,河南郑州450052 [2]郑州大学第一附属医院介入放射科,河南郑州450052 [3]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《中国介入影像与治疗学》2018年第8期473-476,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的采用Meta分析对比观察影像引导下穿刺硬化术与腹腔镜下开窗引流术治疗非寄生虫性肝囊肿的安全性和有效性。方法通过计算机检索PubMed、Web of Science、中国知网、维普、万方数据库及中国生物医学文献数据库,收集有关影像引导下穿刺硬化术及腹腔镜下开窗引流术治疗非寄生虫性肝囊肿的临床对照试验,检索时限为建库至2017年12月。严格按照纳入及排除标准筛选文献后,进行资料提取及质量评价。采用STATA 14.0统计分析软件进行Meta分析。结果最终纳入9篇文献,共659例患者。Meta分析结果显示,与腹腔镜下开窗引流术相比,影像引导下穿刺硬化术的手术时间[标准均数差(SMD)=-2.82,95%CI(-3.80,-1.83),P<0.01]、患者住院时间[SMD=-1.89,95%CI(-2.54,-1.24),P<0.01]均较短,且治疗费用[SMD=-28.77,95%CI(-36.89,-20.66),P<0.01]较低,但复发率[比值比(OR)=2.04,95%CI(1.25,3.35),P<0.01]较高。2种治疗方法术后并发症发生率差异无统计学意义[OR=0.68,95%CI(0.33,1.38),P=0.29]。结论影像引导下穿刺硬化术的安全性与腹腔镜下开窗引流术相似,虽术后复发率较高,但手术时间、患者住院时间更短,治疗费用更低,且更易于操作,适应范围更广。Objective To explore the efficacy and safety of sclerotherapy under imaging guidance compared with laparoscopic fenestration for treatment of non-parasitic hepatic cysts using Meta-analysis.Methods A systematic literature review about clinical control trial of non-parasitic hepatic cysts treated with sclerotherapy under imaging guidance and laparoscopic fenestration was performed based on PubMed,Web of Science,China National Knowledge Internet,VIP,Wanfang databases and China Biology Medicine disc.The time limit was from database establishing to December 2017.The literature obtained with computer-based retrieval were further filtered according to inclusion and exclusion criterions.Then data extraction and the methodological quality evaluation of filtered literatures were performed.Mate-analysis was done with STATA 14.0 software.Results Totally 9 studies were enrolled for Meta-analysis,involving 659 patients.Compared with laparoscopic fenestration,the operation time（standardized mean difference [SMD]=-2.82,95%CI[-3.80,-1.83],P〈0.01）and hospital stay（SMD=-1.89,95%CI[-2.54,-1.24],P〈0.01）of sclerotherapy under imaging guidance were significantly shorter,and the treatment cost（SMD=-28.77,95%CI[-36.89,-20.66],P〈0.01）was significantly lower,while the recurrence rate（odds ratio[OR]=2.04,95%CI[1.25,3.35],P〈0.01）was significantly higher.No statistically significant difference of complication was found between sclerotherapy under imaging guidance and laparoscopic fenestration for non-parasitic hepatic cysts（OR=0.68,95%CI[0.33,1.38],P=0.29）.Conclusion The safety of sclerotherapy under imaging guidance and laparoscopic fenestration for non-parasitic hepatic cysts are similar.Though the recurrence rate is higher,the operation time and the hospital stay are shorter,and the cost is lower of sclerotherapy under imaging guidance compared with those of laparoscopic fenestration.Sclerotherapy under imaging guidance is easy to operate with wide range of indications for treatment of non-parasitic hepatic cys

关 键 词：腹腔镜开窗术 穿刺硬化术 非寄生虫性肝囊肿 META分析 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]