摘要
目的:通过Meta分析了解妇科良性疾病患者腹腔镜与开腹手术的术后静脉血栓发生率。方法:检索2000至2016年中国生物医学文献数据库(CBMdisc)、中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库、Pub Med、荷兰医学文摘数据库(EMBASE)、Web of science等数据库收录的有关妇科良性疾病患者行腹腔镜与开腹手术的术后静脉血栓发生率的相关文献,按纳入及排除标准筛选文献、提取资料并评价质量。采用Stata 13.0软件进行Meta分析,并对年龄、性别及区域等因素进行亚组分析。结果:共纳入相关文献24篇。Meta结果表明,腹腔镜和开腹手术均能增加患者术后的D-二聚体浓度,差异无统计学意义(SMD=0.77,95%CI为-0.08~1.63,P=0.075)。腹腔镜组的术后VTE发生率0.0%~14.03%,平均2.10%;开腹手术组的术后VTE发生率0.63%~14.28%,平均4.90%。Meta结果表明,行腹腔镜手术患者的术后VTE发生率较行开腹手术者低,差异有统计学意义(OR=0.42,95%CI为0.33~0.54,P<0.001)。结论:对于妇科手术患者,腹腔镜和传统开腹手术都会造成术后D-二聚体浓度增高,开腹手术组增高更明显,但结论尚需更深入的验证;对于妇科手术患者,腹腔镜手术较传统开腹手术的术后VTE发生率低。
Objective： To compare the difference of venous thromboembolism（ VTE） after two different surgical methods among people with benign gynecological diseases. Methods：Studies on relative English and Chinese database such as China biology medicinedisc（ CBMdisc）,China national knowledge infrastructure（ CNKI）,VIP database（ VIP）,Wan Fang,Pub Med,Excerpta medica database（ EMBASE）,Web of science on venous thromboembolism after two different surgical methods among people with benign gynecological diseases between 2000 and2016 were searched.Stata 13.0 software was used to analyze the data.Results： This study included 24 papers from the literature.The results of meta-analysis showed that laparoscopic and laparotomy increased the concentration of D-dimer after gynecologic surgery,while it was higher after laparotomy compared with laparoscopic（ SMD = 0.77,95%CI =-0.08 ~ 1.63,P = 0.075）. The incidence of VTE after laparoscopic surgery was 0.0% to 14.03%,with an average incidence of2.10%.The incidence of VTE in the laparotomy group was 0.63% to 14.28%,with an average incidence of 4.90%.The results of meta-analysis showed that the incidence of VTE after laparotomy was significantly higher than that of laparoscopic surgery（ OR = 0.42,95%CI = 0.33 ~ 0.54,P0. 001）. Conclusion： Laparoscopic surgery and traditional laparotomy also can increase the coagulation and fibrinolysis postoperatively in the patients of obstetrics and gynecology,while the abnormality in laparotomy group is more obvious.For gynecological surgery patients,laparoscopic surgery has less postoperative complication of venous thromboembolism,when compared with laparotomy.
出处
《现代妇产科进展》
CSCD
北大核心
2018年第2期81-85,共5页
Progress in Obstetrics and Gynecology
基金
江苏省十三五强卫工程创新团队资助课题(苏卫科教[2017]1号文61号)
南通市科技课题(No:MS222015096)
