安置肠梗阻导管与支架治疗梗阻性结直肠癌的Meta分析  

Meta-analysis of obstruction catheter and stent for colorectal cancer patients complicated with intestinal obstruction

作　　者：熊海波 侯能易[2] 刘培曦 何雪铼 余松 胡雪梅[2] 许杰 庞明辉 Xiong Haibo;Hou Nengyi;Liu Peixi;He Xuelai;Yu Song;Hu Xuemei;Xu Jie;Pang Minghui(Clinical Medicine College,Southwest Medical University,Luzhou 646000,China;Department of Gastrointestinal Surgery,Sichuan Academy of Medical Sciences&Sichuan Province People′s Hospital,Chengdu 610072,China;Department of Gastroenterology,Sichuan Academy of Medical Sciences&Sichuan Province People′s Hospital,Chengdu 610072,China)

机构地区：[1]西南医科大学临床医学院,646000 [2]四川省医学科学院•四川省人民医院胃肠外科,成都6100722 [3]四川省医学科学院•四川省人民医消化内科,成都610072

出　　处：《中华结直肠疾病电子杂志》2020年第4期370-376,共7页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：四川省卫生厅基金(No.130163);四川省医学科学院•四川省人民医院临床研究与转化基金(No.2017LY05)。

摘　　要：目的通过Meta分析评价术前安置肠梗阻导管与支架治疗梗阻性结直肠癌的便捷性与有效性。方法利用PubMed、The Cochrane Library、FMRS、维普数据库、万方数据库和中国知网数据库,检索时间均为从数据库建库至2020年3月,利用RevMan5.3软件对两种治疗方法的便捷性和有效性指标进行Meta分析。结果最终纳入17篇随机对照研究文献,共1136例患者。其中导管组566例,支架组570例。导管组安置时间、安置费用、安置成功率均优于支架组,差异有统计学意义(Z=28.70,4.66,3.22;P<0.05);支架组腹痛腹胀缓解时间、肠道准备时间、住院时间均优于导管组,差异有统计学意义(Z=4.15,2.31,2.92;P<0.05)。两组安置前后肠管内径减小差异、安置后手术并发症比较,差异无统计学意义(P>0.05)。腹痛腹胀缓解时间的漏斗图提示无发表偏倚(P=0.075)。结论现有证据表明,安置肠梗阻导管较支架在梗阻性结直肠癌的治疗过程中,具有经济、快捷和高成功率优势,但缓解腹痛腹胀较慢、术前肠道准备时间和住院时间更久。Objective To evaluate the convenience and effectiveness of preoperative placement of obstruction catheter and stent in the treatment of obstructive colorectal cancer through a meta-analysis.Methods A study search was undertaken in PubMed,the Cochrane Library,FMRS,VIP,Wanfang and CNKI database from the date of their establishment to March 2020.RevMan 5.3.software was used to analyze the convenience and effectiveness of the two methods.Results A total of 1136 patients were included in 17 randomized controlled studies,including 566 patients in the catheter group and 570 patients in the stent group.Operation time,expenditure,rate of success in the catheter group were better than those in the stent group,with statistically significant differences(Z=28.70,4.66,3.22;P<0.05).Relief time of abdominal pain and distention,intestinal preparation time,hospitalization time in the the stent group were better than those in the catheter group,with statistically significant differences(Z=4.15,2.31,2.92;P<0.05).However,no differences were observed in the reduction of the bowel diameter and postoperative complications(P>0.05).There was no evidence of publication bias in studies used for relieving time of abdominal pain and distention(P=0.075).Conclusions Current evidence indicates that the obstruction catheter is more economical,faster and higher success rate,but it is slower relieving abdominal pain and distention and longer preoperative intestinal preparation time and hospitalization time than the stent during the treatment of obstructive colorectal cancer.

关 键 词：结直肠肿瘤 肠梗阻 支架 肠梗阻导管 META分析 

分 类 号：R735.34[医药卫生—肿瘤]