注射肉毒毒素治疗巨结肠术后梗阻症状和小肠结肠炎疗效的Meta分析  

Effect of botulinum toxin injection on postoperative obstruction and enterocolitis of Hirschsprung disease:a Meta-analysis

作　　者：纳钊[1] 白强[1] 陈莉[1] 方辉[1] 杨航 李传新 Na Zhao;Bai Qiang;Chen Li;Fang Hui;Yang Hang;Li Chuanxin(Department of General Surgery,Kunming Children's Hospital,Kunming 650028,China)

机构地区：[1]昆明市儿童医院普外科,昆明650028

出　　处：《中华小儿外科杂志》2025年第1期36-43,共8页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨注射肉毒毒素治疗巨结肠术后梗阻症状和小肠结肠炎的临床效果及不良反应发生情况。方法检索PubMed、Embase、Cochrane library、Web of Science、中国生物医学文献数据库、中国知网、维普和万方数据库中建库至2023年1月收录的注射肉毒毒素治疗巨结肠术后梗阻症状和(或)小肠结肠炎的相关文献。文献筛选后依据纽卡斯尔-渥太华量表评价文献质量,提取相关数据,采用Stata 16.0软件对第一次注射肉毒毒素的短期(随访时间≤3个月)效果、末次注射肉毒毒素的中远期(随访时间>3个月)效果、注射肉毒毒素后小肠结肠炎改善情况以及注射肉毒毒素的不良反应进行Meta分析。结果共18篇文献(377例患儿)纳入研究。第一次注射肉毒毒素治疗巨结肠术后梗阻症状短期效果显著,有效率为76%(95%CI为0.69~0.83,P<0.001)。注射肉毒毒素治疗巨结肠术后梗阻症状中远期效果显著,有效率为54%(95%CI为0.40~0.69,P<0.001)。注射肉毒毒素治疗巨结肠术后小肠结肠炎效果显著,有效率为63%(95%CI为0.30~0.91,P<0.001)。注射肉毒毒素后存在不良反应,不良反应发生率为18%(95%CI为0.08~0.29,P<0.001)。结论注射肉毒毒素治疗巨结肠术后梗阻性症状在短期及中远期有效,能有效改善巨结肠术后小肠结肠炎的发作,但存在轻微和暂时的不良反应。Objective To explore the clinical efficacy and adverse events of botulinum toxin injection for treating postoperative obstructive symptoms and enterocolitis following Hirschsprung disease.MethodsThe PubMed,Embase,Cochrane library,Web of Science,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,VIP and Wanfang databases were searched from inception to January 2023 for the relevant literatures of botulinum toxin injection for treating postoperative obstructive symptoms and(or)enterocolitis of Hirschsprung disease.After literature screening,the quality of the literature was evaluated according to the Newcastle-Ottawa Scale(NOS).Relevant data were extracted,and Stata 16.0 software was used to evaluate the short-term(follow-up time≤3 months)effects of the first injection of botulinum toxin and the mid-term and long-term(follow-up time>3 months)effects of the last injection of botulinum toxin.The effect,the improvement of enterocolitis after botulinum toxin injection,and the adverse events of botulinum toxin injection were explored in the Meta-analysis.ResultsA total of 18 articles representing 377 children were included in the study.The first injection of botulinum toxin had a significant short-term effect on treating obstructive symptoms after megacolon surgery,with an effective rate of 76%(95%CI:0.69-0.83,P<0.001).Botulinum toxin injection had significant mid-term and long-term effects on treating obstructive symptoms after megacolon surgery,with an effective rate of 54%(95%CI:0.40-0.69,P<0.001).Botulinum toxin injection had a significant effect on the treatment of enterocolitis after megacolon surgery,with an effective rate of 63%(95%CI:0.30-0.91,P<0.001).There were adverse events after botulinum toxin injection,with the incidence of 18%(95%CI:0.08-0.29,P<0.001).ConclusionsInjection of botulinum toxin is effective in the short-term,medium-term and long-term outcome of obstructive symptoms after Hirschsprung's surgery,and it can effectively improve the onset of enterocolitis after Hirs

关 键 词：先天性巨结肠 肉毒毒素 小肠结肠炎 META分析 

分 类 号：R726.5[医药卫生—儿科]