全结肠切除术与次全结肠切除术治疗慢传输型便秘的meta分析  

Total colectomy and subtotal colectomy for treating slow transit constipation:a meta-analysis

作　　者：桂鹏 黄卫 GUI Peng;HUANG Wei(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,重庆402160

出　　处：《重庆医学》2023年第22期3475-3480,共6页Chongqing medicine

摘　　要：目的比较次全结肠切除术(SC)与全结肠切除术(TC)治疗慢传输型便秘(STC)的安全性与疗效。方法系统检索PubMed、The Cochrane Library、Embase、中国生物医学、中国知网、万方等中英文数据库,检索时间为建库至2023年4月。由两名独立的研究者进行文献筛选、数据提取,使用Stata16.0软件对提取数据进行meta分析。结果最终纳入23篇文献,其中随机对照试验(RCT)7篇,非RCT 16篇,共1500例患者,其中行TC患者730例,SC患者770例。meta分析结果显示,两种手术在术后便秘复发率、手术时间、术后满意度、手术有效率、术后首次排气时间上差异均无统计学意义(P>0.05),SC术后总并发症发生率(OR=0.57,95%CI:0.44~0.74,P<0.001)、术后肠梗阻发生率(OR=0.64,95%CI:0.45~0.93,P=0.020)均低于TC,TC术后围手术期止泻药物使用率(OR=3.51,95%CI:2.26~5.45,P<0.001)高于SC,且住院时间(WMD=-2.22,95%CI:-2.99~-1.46,P<0.001)更短。结论SC治疗STC在降低并发症方面更有优势,安全性更高,且缩短了住院时间,提高了患者术后生活质量。Objective To compare the safety and efficacy of total colectomy(TC)and subtotal colectomy(SC)in the treatment of slow transit constipation.Methods The English databases of PubMed,Cochrane Library,Embase,CBM,CNKI and WangFang were retrieved.The retrieval time was from the database establishment to April 2023.The two independent researchers conducted the literature screening and data extraction.The meta analysis on the extracted data was performed by the Stata16.0 software.Results A total of 23 literatures were included,including 7 randomized controlled trials(RCT)and 16 non-RCT.There were 1500 patients,including 730 patients by TC and 770 patients by SC.The meta analysis results showed that there was no statistically significant difference in the the recurrence rate of constipation,operation time,postoperative satisfaction,operation effective rate and postoperative first exhausting time(P>0.05),the incidence rate of postoperative total complications(OR=0.57,95%CI:0.44-0.74,P<0.001),the occurrence rate of postoperative intestinal obstruction(OR=0.64,95%CI:0.45-0.93,P=0.020)in SC were lower than those in TC,the use rate of postoperative antidiarrheal drugs during the perioperative period in TC(OR=3.51,95%CI:2.26-5.45,P<0.001)was higher than that in SC,moreover the hospital stay(WMD=-2.22,95%CI:-2.99 to-1.46,P<0.001)was shorter.Conclusion SC has the advantage in the aspect of reducing the complications,has high safety,shorten the hospitalization duration,increase the living quality of the patients and is worthy of promotion in treating STC.

关 键 词：便秘 次全结肠切除术 全结肠切除术 META分析 

分 类 号：R605[医药卫生—外科学]