摘要
目的:系统评价早期腹腔镜胆囊切除术(ELC)与延期腹腔镜胆囊切除术(DLC)治疗急性胆囊炎的临床效果及安全性。方法:计算机检索PubMed、EMbase、CENTRAL、MEDLINE、Cochrane、WANFANG、中文科技期刊等数据库,查找所有比较ELC与DLC治疗急性胆囊炎疗效的随机对照试验文献,检索时限为建库至2014年5月,按照纳入排除标准由两名独立的研究人员进行文献选择、数据提取及质量评价,参照Cochrane协作网推荐的方法使用RevMan 5.2软件进行Meta分析。结果:共纳入6项研究,总计368例患者。Meta分析显示:两组间的并发症发生率(OR:0.74,95%CI:0.43-1.30;P=0.74)、中转开腹率(OR:0.81,95%CI:0.46-1.42;P=0.47),差异无统计学意义。与DLC相比,ELC有更短的总住院时间(MD:-8.38,95%CI:-12.37--4.39;P≤0.000 1),更长的手术时间(MD:18.88,95%CI:9.34-28.41;P=0.000 1),差异有统计学意义。结论:72h内的早期腹腔镜胆囊切除术治疗急性胆囊炎安全有效,相比与延期腹腔镜胆囊切除术可缩短住院时间,减轻病人的经济负担,可能是治疗急性胆囊炎的最佳手术时机。
Objective：To systematically evaluate the clinical efficacy and safety of early laparoscopic cholecystectomy（ELC）versus delayed laparoscopic cholecystitis（DLC）.Methods：The data of controlled trials to compare ELC with DLC for acute cholecystitis were searched in PubMed,CENTRAL,MEDLINE,Cochrane,WANFANG and Chinese Technology Periodical Database from establishment to May 2014.Data were extracted and evaluated by two independent researchers.The quality of the included trials was evaluated.Meta-analyses were conducted by using the Cochrane Collaboration＇s RevMan 5.2software.Results：Six controlled clinical trials（n=368）were included.The meta-analysis showed there were no statistically significant difference between ELC group and DLC group in the rate of conversion to open cholecystectomy（OR：0.81,95%CI：0.46-1.42;P=0.47）or complications（OR：0.74,95%CI：0.43-1.30;P=0.74）.TheELC group was significantly shorter than the DLC group in the total hospital stay（MD：-8.38,95%CI：-12.37--4.39;P≤0.000 1）and was significantly longer in operation time（MD：18.88,95%CI：9.34-28.41;P=0.000 1）.Conclusion：Compared with the late cholecystectomy,early cholecystectomy in 72 hours is safe and effective,can shorten hospitalization time,reduce the economic burden of patients,and may be the optimal timing of surgery for the treatment of acute cholecystitis.
出处
《武汉大学学报（医学版）》
CAS
2015年第3期483-487,共5页
Medical Journal of Wuhan University
