脾部分切除术与全脾切除术治疗外伤性脾破裂疗效比较Meta分析  

Comparison of clinical efficacy between partial and total splenectomy for traumatic splenic rupture: a Meta-analysis

作　　者：贾峰[1] 王鑫璐 武波 刘亚辉[1] Jia Feng;Wang Xinlu;Wu Bo;Liu Yahui(Department of Hepatobiliary and Pancreatic Surgery,the First Hospital of Jilin University,Changchun 130021,China;Department of Pharmacy,the First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院肝胆胰外二科,长春130021 [2]吉林大学第一医院药学部,长春130021

出　　处：《中华肝脏外科手术学电子杂志》2022年第1期27-31,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：吉林省自然科学基金(20200201417JC);吉林省卫生健康技术创新项目(2017J047);吉林省医疗卫生人才专项(3D5197909428)。

摘　　要：目的比较脾部分切除术(PS)和全脾切除术(TS)治疗外伤性脾破裂的临床疗效。方法检索建库至2020年7月期间PubMed、Cochrane Library、Embase、Web of Science和中国知网、万方、维普数据库中的相关文献。英文检索词:splenectomy,total splenectomy,partial splenectomy,spleen partial splenectomy,rupture of spleen,rupture splenic,ruptures splenic,splenic rupture,splenic ruptures。中文检索词:脾切除术、全脾切除术、脾完全切除术、部分脾切除术、脾部分切除术、脾破裂。对纳入文献提取手术时间、术中出血量、住院时间、术后并发症等进行Meta分析,评价两种术式的临床疗效。结果最终纳入10篇文献,共599例患者。PS组289例,TS组310例。Meta分析结果显示,PS组住院时间明显少于TS组(MD=-4.31,95%CI:-6.40~-2.22,P<0.05)。PS组术后总体并发症发生率明显低于TS组(RR=0.28,95%CI:0.20~0.39,P<0.05)。其中PS组术后感染(RR=0.31,95%CI:0.17~0.55,P<0.05)、肠梗阻(RR=0.35,95%CI:0.14~0.87,P<0.05)、静脉血栓(RR=0.24,95%CI:0.07~0.82,P<0.05)的发生率明显低于TS组。而PS组手术时间(MD=-6.11,95%CI:-22.92~10.70,P>0.05)及术中出血量(MD=4.64,95%CI:-68.74~78.02,P>0.05)与TS组比较差异无统计学意义。结论与TS相比,PS术后并发症少,住院时间短,对外伤性脾破裂患者的预后更具优势。Objective To compare the clinical efficacy between partial splenectomy (PS) and total splenectomy (TS) in the treatment of traumatic splenic rupture.Methods Relevant literature was retrieved in PubMed,Cochrane Library,Embase,Web of Science,CNKI,Wanfang Data and VIP databases from the inception of database to July 2020.The key words in English included splenectomy,total splenectomy,partial splenectomy,spleen partial splenectomy,rupture of spleen,rupture splenic,ruptures splenic,splenic rupture and splenic ruptures.The key words in Chinese consisted of splenectomy,total splenectomy,partial splenectomy and splenic rupture.The operation time,intraoperative blood loss,length of hospital stay and incidence of postoperative complications of the included studies were subjected to Meta-analysis.Clinical efficacy between PS and TS was evaluated.Results 10 articles consisting of 599 patients were eventually included.289 patients were assigned into the PS group and 310 cases into the TS group.Meta-analysis revealed that the length of hospital stay in the PS group was significantly shorter than that in the TS group (MD=-4.31,95%CI:-6.40 to-2.22,P<0.05).The incidence of postoperative complications in the PS group was significantly lower than that in the TS group (RR=0.28,95%CI:0.20 to 0.39,P<0.05).In the PS group,the incidences of postoperative infection (RR=0.31,95%CI:0.17 to 0.55,P<0.05),intestinal obstruction (RR=0.35,95%CI:0.14 to 0.87,P<0.05) and venous thrombosis (RR=0.24,95%CI:0.07 to 0.82,P<0.05) were significantly lower than those in the TS group.The operation time (MD=-6.11,95%CI:-22.92 to 10.70,P>0.05) and intraoperative blood loss (MD=4.64,95%CI:-68.74 to 78.02,P>0.05) in the PS group did not significantly differ compared with those in the TS group.Conclusions Compared with TS,PS causes fewer complications and shorter length of hospital stay,which has more advantageous for clinical prognosis of patients with traumatic splenic rupture.

关 键 词：脾切除术 脾破裂 META分析 

分 类 号：R657.6[医药卫生—外科学]