腹腔镜腹膜代阴道成形术与乙状结肠代阴道成形术疗效对比的Meta分析  

A meta-analysis of the effect of laparoscopicperitoneal vaginoplasty and sigmoid vaginoplasty

作　　者：程健 余莹 张磊[2] 秦克旺 Cheng Jian;Yu Ying;Zhang Lei(The Second Clinical Medical School of Southern Medical University,Guangzhou510000;Guangdong Second People's Hospital,Guangzhou510317;Spleen-Stomach Diseases Institute,Guangzhou University of Chinese Medicine,Guangzhou510405)

机构地区：[1]南方医科大学第二临床医学院,广州510000 [2]广东省第二人民医院,广州510317 [3]广州中医药大学脾胃研究所,广州510405

出　　处：《现代妇产科进展》2018年第12期891-895,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:评价腹腔镜腹膜代阴道成形术与腹腔镜乙状结肠代阴道成形术的临床疗效,为临床上阴道成形术术式选择提供参考依据。方法:计算机检索外文数据库:Cochrane Library、Pubmed、EMbase,以及国内数据库万方数据库(Wanfang)、维普数据库(VIP)、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM),检索时限从建库至2018年3月31日。按纳入标准筛选文献,文献质量评价应用Cochrane风险评估偏倚工具,辅以NOS质量评价量表完成。应用Review Manager 5.3软件对手术时间、术中出血量、术后住院时间、术后性生活满意度进行Meta分析。结果:最终纳入文献9篇,其中腹膜组159例,乙状结肠组163例。Meta分析结果显示,腹膜组与乙状结肠组的手术时间(MD=-90.82,95%CI为-101.13～-80.52,P<0.00001)、术中出血量(MD=-42.76,95%CI为-56.93～-28.59,P<0.00001)、术后住院时间(MD=-3.46,95%CI为-4.03～-2.90,P<0.00001)、术后性生活满意度(MD=0.52,95%CI为0.15～0.90,P=0.007)比较,差异均有统计学意义。结论:腹腔镜腹膜代阴道成形术能更好地缩短手术时间及术后住院时间,减少术中出血量,患者术后性生活满意度更高,具有良好的应用前景,但仍需设计严谨的多中心、大规模、高标准化研究进一步验证。Objective:To evaluate the clinical efficacy of laparoscopic peritoneal vaginoplasty and laparoscopic sigmoid vaginoplasty,and to provide a reference for clinical selection of surgical procedures for vaginoplasty.Methods:Searching from foreign language databases:Cochrane Library,Pubmed,EMbase,and domestic databases:Wanfang,VIP,CNKI,and CBM,Searching time limit from construction to Mar 31.2018,Screening criteria-compliant literature according to inclusion criteria.Cochrane risk assessment bias tools were used for quality assessment.Appling Review Manager 5.3 software to take a meta-analysis of operative time,amount of intraoperative bleeding,average hospitalization time after operation,postoperative sexual satisfaction.Results:There were 9 studies that met the inclusion criteria,including 159 cases in peritoneal groupand 163 cases in sigmoid group.Meta-analysis showed that there were statistically significant differences in the two groups of the operativetime(MD=-90.82,95%CI=-101.13^-80.52,P<0.00001),amount of intraoperative bleeding(MD=-42.76,95%CI=-56.93^-28.59,P<0.00001),average hospitalization time after operation(MD=-3.46,95%CI=-4.03^-2.90,P<0.00001),postoperative sexual satisfaction(MD=0.52,95%CI=0.15~0.90,P=0.007).Conclusion:Laparoscopic peritoneal vaginoplasty can better shorten the operative time and average hospitalization time after operation,reduce the amount of intraoperative bleeding,and postoperative satisfaction with sexual life is much higher.It has a good application prospects.However,it still needs to be designed with further rigorous multi-center,large-scale,high-standardization studies to further verify.

关 键 词：先天性无阴道 腹膜代阴道成形术 乙状结肠代阴道成形术 META分析 

分 类 号：R713.3[医药卫生—妇产科学]