ERAT与LA治疗成人急性无并发症性阑尾炎疗效及安全性的Meta分析  

A Meta analysis on efficacy and safety of ERAT and LA for treating adult acute non-complication appendicitis

作　　者：祝凯 王于梅 代敏慧 张钰华[1] 刘忠和 张艳芳 熊小平 ZHU Kai;WANG Yumei;DAI Minhui;ZHANG Yuhua;LIU Zhonghe;ZHANG Yanfang;XIONG Xiaoping(Medical College,Jishou University,Jishou,Hunan 416000,China;Department of Gastroenterology,Qianjiang Central Hospital,Chongqing 409000,China)

机构地区：[1]吉首大学医学院,湖南吉首416000 [2]重庆市黔江中心医院消化内科,重庆409000

出　　处：《检验医学与临床》2024年第1期45-48,共4页Laboratory Medicine and Clinic

基　　金：吉首大学研究生科研创新项目(JGY2022082)。

摘　　要：目的 比较内镜逆行阑尾炎治疗术(ERAT)和腹腔镜阑尾切除术(LA)治疗成人急性无并发症性阑尾炎的临床疗效及安全性差异。方法 检索PubMed、Cochrane Library、Web of Science、Embase、中国生物医学文献数据库(SinoMed)、中国知网(CNKI)、万方数据库和中国科学期刊数据库自建立之日起至2022年12月1日采用ERAT与LA治疗成人急性无并发症性阑尾炎的随机对照研究、回顾性研究和前瞻性研究。采用RevMan5.3软件对最终统计的数据进行Meta分析。采用统计量I2评估研究的异质性。通过固定效应或随机效应模型计算95%置信区间(CI)的优势比(OR)、加权平均差(WMD)。结果 ERAT组的手术时间(WMD=-19.46,95%CI:-27.36~-11.55,P<0.001)、术后体温恢复正常时间(WMD=-0.92,95%CI:-1.13~-0.71,P<0.001)、白细胞计数降至正常时间(WMD=-1.79,95%CI:-2.55~-1.02,P<0.001)、术后持续卧床时间(WMD=-1.77,95%CI:-2.34~-1.20,P<0.001)、术后住院时间(WMD=-2.77,95%CI:-3.63~-1.91,P<0.001)均短于LA组,且并发症(OR=0.26,95%CI:0.12~0.54;P=0.000 3)发生率更低。结论 相较于LA,ERAT治疗成人急性无并发症性阑尾炎更具优势。不仅减少了患者的痛苦,节约了医疗资源,还保留了阑尾的生物学功能,具有较大的临床推广及应用价值。Objective To compare the differences in the efficacy and safety between endoscopic retrograde appendicitis therapy(ERAT)and laparoscopic appendectomy(LA)in the treatment of adult acute non-complication appendicitis.Methods The databases of PubMed,Cochrane Library,Web of Science,Embase,Chinese Biomedical Literature Database(SinoMed),China National Knowledge Infrastructure(CNKI),Wanfang Database and Chinese Science Journal Database were retrieved for the randomized controlled trials(RCT)and retrospective studies of ERAT versus LA in the treatment of adult acute non-complication appendicitis from the date of their establishment to December 1,2022.The Meta analysis on the final statistical data was performed by using RevMan5.3 software.The heterogeneity was assessed by using the statistic I 2.The odds ratio(OR),weighted mean difference(WMD)for 95%confidence intervals(CI)were calculated by using fixed effects or random effects models.Results The operation time(WMD=-19.46,95%CI:-27.36 to-11.55,P<0.001),time of postoperative body temperature recovery to normality(WMD=-0.92,95%CI:-1.13 to-0.71,P<0.001),time of WBC count to normality(WMD=-1.79,95%CI:-2.55 to-1.02,P<0.001),postoperative continuous bed rest time(WMD=-1.77,95%CI:-2.34 to-1.20,P<0.001)and postoperative duration of hospital stay(WMD=-2.77,95%CI:-3.63 to-1.91,P<0.001)in the ERAT group were shorter than those in the LA group,moreover the incidence rate of complications(OR=0.26,95%CI:0.12 to 0.54;P=0.0003)was lower.Conclusion ERAT is superior to LA in the treatment of adult acute non-complication appendicitis.It not only reduces the pain of the patients,saves the medical resources,but also preserves the biological function of the appendix,which has great value of clinical promotion and application.

关 键 词：内镜逆行阑尾炎治疗术 腹腔镜阑尾切除术 急性无并发症性阑尾炎 META分析 疗效 

分 类 号：R656.8[医药卫生—外科学]