硬化治疗与腹腔镜治疗非寄生虫性肝囊肿的系统评价  

Systematic evaluation of sclerotherapy and laparoscopy in the treatment of nonparasitic hepatic cysts

作　　者：何承峻[1] 陈廷昊 杨小丁 刘李 陈海洋 HE Chengjun;CHEN Tinghao;YANG Xiaoding;LIU Li;CHEN Haiyang(Department of General Surgery,the First People′s Hospital of Ziyang City,Ziyang,Sichuan 641300,China)

机构地区：[1]资阳市第一人民医院普外科

出　　处：《现代医药卫生》2019年第19期2985-2988,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨经皮肝穿硬化治疗对非寄生虫性肝囊肿的疗效是否优于腹腔镜手术。方法通过检索PubMed、Embase、Cochrane、中国知网及万方数据库,关于肝囊肿与穿刺引流、硬化治疗、腹腔镜治疗方面的随机对照试验或回顾性病例对照研究(检索时间为2008年1月至2018年6月),对符合标准的文献进行质量评价和数据提取,采用RevMan5.3统计学软件进行meta分析。结果10篇文献共819患者纳入研究。对比腹腔镜手术、硬化治疗手术时间[均数差(MD)=-24.17,95%可信区间(95%CI)-36.11^-12.22,P<0.00001)]、住院时间(MD=-2.15,95%CI-2.67^-1.63,P<0.00001)、复发人数[优势比(OR)=2.43,95%CI1.46~4.03,P<0.0006)]有差异,引流时间(MD=-0.12,95%CI-0.41~0.16,P<0.40)、并发症总人数(OR=1.21,95%CI0.73~2.02,P=0.46)无差异。结论经皮肝穿引流硬化治疗手术时间、住院时间较腹腔镜有缩短,而肝囊肿复发率较腹腔镜更高。Objective To determine whether the outcomes of sclerotherapy were superior to laparoscopic fenestration(LF)for non-parasitic hepatic cyst.Methods Database of PubMed,Embase,Cochrane,CNKI and Wanfang were searched for the randomized controlled trials or retrospective case-control studies which were related to the comparison between sclerotherapy and LF in the treatment of non-parasitic hepatic cyst(retrieval time was from January 2008 to June 2018).After the quality evaluation and the data extraction of the literatures,statistical software of RevMan5.3 was used to perform meta analysis.Results A total of 819 patients were included in 10 literatures.Compared to the LF group,the operation time(MD=-24.17,95%CI-36.11--12.22,P<0.000 01),hospital stay(MD=-2.15,95%CI-2.67--1.63,P<0.000 01),recurrence rate(OR=2.43,95%CI 1.46-4.03,P<0.000 6)in the sclerotherapy group were different,and the indwelling drainage(MD=-0.12,95%CI-0.41-0.16,P<0.40),postoperative complications(OR=1.21,95%CI 0.73-2.02,P=0.46)in the sclerotherapy group were not different.Conclusion The operative time and hospitalization time of percutaneous transhepatic drainage are shorter than those of LF,and the recurrence rate of hepatic cyst is higher than that of LF.

关 键 词：腹腔镜 肝疾病 硬化疗法 肝囊肿 腹腔镜开窗 

分 类 号：R657.3[医药卫生—外科学]