摘要
目的 评价胃癌术后腹腔引流的有效性和安全性。方法采用Cochrane系统评价方法，检索PubMed（1976—2008）、EmbaSe（1982．2008）、Cochrane library（2007年第3期）、中国生物医学文献数据库（CBM1979—2008）、中文科技期刊全文数据库（CSJD1989—2008）和中国期刊全文数据库（CJFD1994-2008），并辅以手工检索和其他检索；由两名评价员独立评价并交叉核对纳入研究的质量．采用RevMan4．2．10软件进行Meta分析。结果初检47篇文献，最终纳A3篇RCT进行分析。共计338例胃癌患者，其中全胃切除160例，次全胃切除178例；术后不放腹腔引流患者167例。Meta分析结果显示：放腹腔引流与不放腹腔引流相比，不良事件（分别为肺部感染、切口感染、腹腔脓肿、吻合口瘘和住院死亡）发生率差异无统计学意义，其OR值和95％CI分别为[1．23（0．49～3．07）、1．09（0．36～3．29）、1．28（0．28～5．8）、1．53（0．25～9．42）和1．78（0．37-8．56）]。两组术后进食时间和术后住院天数的WMD值和95％CI分别为[0．12（-0．11-0．35）和0．65（0．03～1．26）]。结论胃癌术后可能没有放腹腔引流的必要性。
Objective To assess the efficacy and safety of gastrectomy abdominal drainage after gastrectomy in gastric cancer patients. Methods Cochrane systematic evaluation was used to search through Cochrane library （2007-No.3） of clinical comparative trail, PubMed （1976-2008）, Embase （1982-2008）, Chinese Biomedical Literature Database （CBM 1979-2008）, Chinese Scientific Journal Full-text Database （CSJD 1989-2008） and Chinese Journal Full-text Database（CJFD1994-2008）, aided with manual retrieval and other retrievals. The quality of the assessment was independently evaluated and cross-checked by two evaluators. The results of homogeneous studies were analyzed with RevMan4.2.10 software. Results A total of 47 articles were retrieved. Three randomized controlled trials were involved. A total of 338 patients were studied. Of the 338 patients, 160 were treated with total gastrectomy, 178 subtotal gastrectomy. Among the 338 patients, 167 were treated without abdominal drainage. Above 3 trials did not report blind method and did not describe method of allocation concealment. No significant differences were found in pulmonary complication, wound infection, intra-abdominal abscess, clinical leakage and initiation of soft diet between abdominal drainage group and without abdominal drainage group. Statistical results showed odds ratio（OR）=1.23, 95% CI-0.49-3.07 for pulmonary complication; OR=1.09,95% CI=0.36-3.29 for wound infection; OR=1.28, 95% CI=0.28-5.8 for intra-abdominal abscess; OR=1.53, 95% CI=0.25-9.42 for anastomotic leakage; OR=1.78, 95% CI=0.37-8.56 for hospital mortality; WMD=0.12, 95% CI=-0.11-0.35 for initiation of soft diet. Besides, significant difference was found in hospital stay （WMD=0.65, 95% CI=0.03-1.26）, and abdominal drainage group was longer. Conclusion Abdominal drainage after gastreetomy should not be recommended as a regular treatment for gastric cancer patients.
出处
《中华胃肠外科杂志》
CAS
北大核心
2009年第5期456-461,共6页
Chinese Journal of Gastrointestinal Surgery
关键词
胃肿瘤
外科手术
腹腔引流
META分析
Stomach neoplasms
Surgical procedures
Abdominal drainage
Meta-analysis
作者简介
通信作者：刘兵。Email：2022410996@sina．com
