中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (02): 150-153.

• 论著 • 上一篇    下一篇

梗阻性黄疸术前胆道引流疗效分析

曹    锋，李    非   

  1. 首都医科大学宣武医院普外科，北京100053
  • 出版日期:2011-02-01 发布日期:2011-05-30

  • Online:2011-02-01 Published:2011-05-30

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摘要：

目的    系统评价梗阻性黄疸术前胆道引流 （preoperative biliary drainage，PBD）的临床效益。 方法    采用Cochrane系统评价方法, 检索1966-2010年Cochrane图书馆临床对照试验数据库、PubMed、Embase、Cancer lit等数据库，2名评价员独立提取信息并评价文献质量后交叉比对，评价指标包括总体病死率、总体并发症发生率及术后并发症发生率，采用RevMan 4.2软件进行Meta分析。 结果    共有8篇文献进入Meta分析，累积样本含量728例。与直接手术组相比，PBD总体病死率（OR 1.08，95%CI 0.68～1.73，P=0.74）、总体并发症发生率（OR 1.72，95%CI 0.86～3.45，P=0.13）及术后并发症发生率（OR 0.6，95%CI 0.35～1.03，P=0.06）差异无统计学意义。 结论    PBD操作本身的并发症抵消了其可能的临床益处，目前临床需慎重开展。

关键词: 梗阻性黄疸, 胆道引流, Meta分析

Abstract:

Therapeutic effect analysis of preoperative biliary drainage for obstructive jaundice        CAO Feng, LI Fei. Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Corresponding author : LI Fei，E-mail：xw_lifei@yahoo.com.cn
Abstract    Objective    To determine the benefits and harms of preoperative biliary drainage (PBD) for obstructive jaundice.  Methods    Cochrane systematic evaluation was used to search data between 1966 and 2010 through Cochrane libraries of clinical comparative trials, PubMed, Embase, Cancer Lit and the Chinese BioMedical Literature on disc. The quality of literatures was independently evaluated and cross-checked by two evaluators. The indicators for assessment included overall mortality, overall morbidity and postoperative morbidity. The results were analyzed with RevMan 4.2 software. Results    Eight articles were involved in the Meta analysis with total 728 patients. No statistical differences were found in the overall mortality（OR 1.08，95%CI 0.68-1.73, P=0.74）, overall morbidity（OR 1.72，95%CI 0.86-3.45, P=0.13） and postoperative morbidity（OR 0.6，95%CI 0.35-1.03, P=0.06） between the groups. Conclusion    The potential benefits of PBD in terms of postoperative rates of death and complications do not outweigh the disadvantage of the drainage procedure and should be performed cautiously now.

Key words: obstructive jaundice, biliary drainage, Meta-analysis