内镜下逆行阑尾炎治疗术治疗急性非穿孔性阑尾炎疗效对比的Meta分析  

Meta-analysis of the efficacy comparison of retrograde endoscopic appendicitis in the treatment of acute non-perforated appendicitis

作　　者：刘琳[1] 段树全[2] 孟宪梅[1] 党彤[1] Liu lin;Duan Shuquan;Meng Xianmei;Dang Tong(Department of Gastroenterology,Second Affiliated Hospital of Baotou Medical College,Baotou 014030,China;Department of Minimally Invasive Digestive Center,Second Affiliated Hospital of Baotou Medical College,Baotou 014030,China)

机构地区：[1]内蒙古包头市包头医学院第二附属医院消化科,包头014030 [2]内蒙古包头市包头医学院第二附属医院消化微创中心,包头014030

出　　处：《中华胃肠内镜电子杂志》2021年第1期18-23,共6页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

基　　金：内蒙古自治区自然科学基金项目(2018MS08050);内蒙古自治区科技计划项目(201803020)。

摘　　要：目的系统性评价内镜下逆行阑尾炎治疗术(ERAT)治疗急性非穿孔性阑尾炎的安全性和有效性。方法检索Pubmed、Cochrane图书馆对照试验注册库、中国期刊全文数据库、万方数据库、维普数据库,自2012年1月至2019年4月有关内镜下逆行阑尾炎治疗术和腹腔镜手术治疗急性非穿孔性阑尾炎的相关文献,采用Cochrane协作网提供的Rev Man 5.3版软件进行统计处理,对纳入资料进行分析,计算OR值或MD值及其95%可信区间(95%CI表示)。结果共入选了16项临床研究,总计1375例患者。Meta分析结果显示:内镜下逆行阑尾炎治疗术和腹腔镜手术治疗急性非穿孔性阑尾炎疗效对比,内镜下逆行阑尾炎治疗术住院时间更短MD(95%CI)=-2.46(-2.93,-1.99),P<0.05、并发症发生率更低OR(95%CI)=0.23(0.16,0.33),P<0.05、手术时间更短MD(95%CI)=-19.89(-21.8,-17.93),P<0.05、术后恢复更快MD(95%CI)=-3.16(-4.13,-2.19),P<0.05。结论内镜下逆行阑尾炎治疗术治疗急性非穿孔性阑尾炎,是一种安全可行的方法,具有手术时间短、住院时间短、患者恢复快、并发症少、美容效果好等诸多优点。但是目前这项治疗方法并未完全普及,本结论还需大规模临床数据加以证实。Objective To explore the feasibility of endoscopic retrograde appendicitis in the treatment of acute non-perforated appendicitis.Method Retrieve the pubmed、cochrane Library Control Test Registration Database,Chinese Journal full text Database,Wanfang Database,Weipu Database,from January 2012 to April 2019 related literature on endoscopic retrograde appendicitis and laparoscopic surgery for acute non-perforated appendicitis,the Cochrane collaboration with Rev Man 5.3 edition software for statistical processing,analyze the heterogeneity in data,calculate the OR value OR MD and its 95%confidence interval.Results 16 clinical studies with a total of 1375 patients were enrolled according to the inclusion criteria.Meta analysis showed that endoscopic retrograde appendicitis treatment and laparoscopic surgery for acute non-perforated appendicitis compared the curative effect,endoscopic retrograde appendicitis treatment of shorter hospital stay MD(95%CI)=-2.46(-2.93,-1.99),P<0.05,Lower incidence of complications OR(95%CI)=0.23(0.160.33),P<0.05,Short operation time MD(95%CI)=-19.89(-21.8,-17.93),P<0.05,and Postoperative recovery was faster MD(95%CI)=-3.16(-4.13,-2.19),P<0.05.Conclusions the results of meta-analysis suggest that endoscopic retrograde appendicitis is a safe and feasible method for the treatment of acute non-perforatedre appendicitis,which has many advantages,such as short operation time,short hospitalization time,rapid recovery of patients,fewer complications,and good cosmetic effect,However,at present,this treatment method is not completely popular,and this conclusion needs to be confirmed by large-scale clinical data.

关 键 词：内镜下逆行阑尾炎治疗术 腹腔镜手术 急性非穿孔性阑尾炎 META分析 

分 类 号：R65[医药卫生—外科学]