摘要
目的通过meta分析，探讨胰十二指肠切除术后发生胃排空延迟的影响因素及其相关危险度。方法通过检索Cochrane Library、Medline、Pubmed、Ovid、Embase，搜集近二十年发表的关于胰十二指肠切除术后发生胃排空延迟影响因素的相关文献，进行meta分析，计算每个危险因素的优势比（OR值）及95％CI。结果meta分析共纳入研究文献26篇，其中6篇RCTs，9篇队列研究，11篇病例对照研究。经meta分析，计算合并OR值分别为：保留幽门2．35（95％CI，0．72—7．61），术后早期肠内营养0．93（95％CI，0．64—1．35），术后腹部并发症6．14（95％CI，3．47—10．85），BillrothⅠ式胃肠重建（与BillrothⅡ相比）4．30（95％CI，1．00—18．43），结肠前胃肠吻合0．12（95％CI，0．05—0．27）。结论胰十二指肠切除术后，腹部并发症是发生胃排空延迟的一个危险因素；保留幽门不增加胃排空延迟的发生率；术后早期肠内营养与胃排空延迟发生无关；结肠前及BillrothⅡ式胃肠重建可能会降低胃排空延迟的发生率。
Objective To assess factors influencing the development of DGE after pancreatieoduodenectomy. Methods Cochrane Library, Medline, Ovid and EMBASE databases were searched to identify studies that evaluated the influencing factors in DGE patients and control subjects after pancreaticoduodenectomy. Odds ratios and 95% confidence intervals（CIs） were then calculated by a meta -analysis. Results Six RCTs, twenty case - control and cohort studies met the inclusion criteria. Compared with control subjects,the risk of DGE was 2.35 for preservation of pylorus（95% CI,0.72 -7.61 ） ,0.93 for postoperative enteral nutrition（95% CI,0.64 - 1.35）, 6. 14 for postoperative intro - abdominal complications （95% CI,3.47 - 10.85） ,4.30 for Billroth Ⅰ type gastrointestinal reconstruction（95% CI, 1.00 - 18.43）, and 0. 12 for antecolic gastrointestinal reconstruction（95% CI, 0.05 - 0.27）. Conclusions Postoperative intro - abdominal complications were the most important factors associated with DGE. There was no significant association between the DGE and the preservation of pylorus. Postoporafive enteral feeding did not show advantages in preventing DGE. Antecolic and Billroth Ⅱ type gastrointestinal reconstruction seem to suggest an improvement in decreasing the incidence of DGE.
出处
《实用肿瘤学杂志》
CAS
2009年第2期118-125,共8页
Practical Oncology Journal
