保胆取石术后结石复发危险因素的Meta分析  

Meta-analysis of the risk factors of stones recurrence after cholecystolithotomy

作　　者：陈治梁 吕永双 余天雾[1] 周健[1] CHEN Zhi-liang;Lü Yong-shuang;YU Tian-wu;ZHOU Jian(Department of Surgery,the Affiliated Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院肝胆外科,重庆402160

出　　处：《中国现代普通外科进展》2020年第5期361-367,共7页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:分析保胆取石术后结石复发的系列危险因素,指导临床胆囊结石患者手术方式的选择。方法:检索2004年1月1日—2019年1月1日发表的关于保胆取石术后结石复发危险因素分析的相关文献,检索数据库为中国知网、万方、维普等中文数据库以及Pubmed、EM-BASE等英文数据库,数据提取完成之后,采用Rev Man5.3软件进行Meta分析,发表偏倚采用Stata 12.0进行检验。结果:共纳入13篇文献6128例患者,术后结石复发的研究因素、OR值及95%可信区间(CI)分别为年龄0.95(0.60,1.49)、性别1.00(0.80,1.26)、BMI≥251.57(1.12,2.21)、胆囊壁厚度≥0.3 cm 3.94(2.30,6.75)、胆囊功能异常3.65(2.44,5.46)、家族史2.03(1.59,2.58)、多发结石3.63(2.43,5.43)、未口服熊去氧胆酸2.90(1.36,6.15)、糖尿病0.86(0.48,1.56)、油腻饮食3.17(2.21,4.55)。结论:胆囊功能异常、多发结石、未口服熊去氧胆酸、有胆结石家族史、胆囊壁厚度≥0.3cm、油腻饮食、BMI≥25是结石复发的危险因素,而年龄、性别、糖尿病与结石复发没有明显联系。Objective:To research the risk factors for the recurrence of stones after cholecystolithotomy,and guide the choice of surgical methods for patients with Cholelithasis.Methed:Published studies were searched in the CNKI,Wan Fang databases,Wei Pu database,Pubmed,EM-BASE and included studies on risk factors for recurrence of stones after cholecystolithotomy that were published between 2004 and 2019.After the data extraction is complete,Rev Man5.3 software was used to achieve Meta-analysis and Stata12.0 was used to test the publication bias.Results: Thirteen studies involving 6128 participants were selected.Advanced age,gender,BMI≥25,gallbladder wall thickening over 0.3cm,dysfunction of the gallbladder,family history of cholelithasis,multiple calculi and not taking oral ursodeoxycholic acid had the pooled OR(95%CI) of 0.95(0.60,1.49), 1.00(0.80,1.26), 1.57(1.12,2.21), 3.94(2.30,6.75), 3.65(2.44,5.46), 2.03(1.59,2.58), 3.63(2.43,5.43), 2.90(1.36,6.15), 0.86(0.48,1.56), 3.17(2.21,4.55). Conclusion: Dysfunction of the gallbladder,multiple calculi and not taking oral ursodeoxycholic acid after cholecystolithotomy,family history of cholelithasis,gallbladder wall thickening over 0.3 cm, BMI≥25, a preference for greasy food are risk factors for recurrence of stone after cholecystolithotomy.However,there is no apparent connection between advanced age, gende,diabetes and recurrence of stone.

关 键 词：保胆取石术 结石 复发 危险因素 

分 类 号：R657.42[医药卫生—外科学]