首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 2016年 2期 门静脉高压症 => 肝纤维化及肝硬化 =>脾切除术与部分脾动脉栓塞术治疗肝..
脾切除术与部分脾动脉栓塞术治疗肝硬化脾功能亢进近期疗效比较的Meta分析
Short-term efficacy of splenectomy versus partial splenic embolization for liver cirrhosis and hypersplenism: a Meta-analysis
文章发布日期:2016年02月06日  来源:  作者:何海冠,沈艺南,庞书杰,等  点击次数:2065次  下载次数:399次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的系统评价部分脾动脉栓塞术(PSE)和脾切除术治疗肝硬化脾功能亢进的疗效。方法计算机检索2005年1月1日-2015年5月30日Medline、Embase、Web of Science、中国知网、万方数据库、维普收录的评估PSE与脾切除术治疗肝硬化脾功能亢进疗效的文献,文献纳入由两位研究者独立筛选,经过质量评价与数据提取后,采用RevMan5.3进行Meta分析。结果最终纳入10篇对照研究,共638例患者。4项研究的合并分析结果显示术后1周PSE组对外周血小板的影响明显低于脾切除术组[加权均数差(WMD)=-65.71,95%可信区间(95%CI): -120.24~-11.18,P=0.02];而术后1个月两组差异无统计学意义(WMD=0.68,95%CI:-8.16~9.52,P=0.88);2项研究的合并分析结果显示术后1个月PSE组自然杀伤细胞的含量较脾切除术组高(WMD= 6.03,95%CI: 3.80~8.26,P<0.001),且术后1年两组差异仍有统计学意义(WMD=3.60,95%CI:1.25~5.96,P=0003);3项研究合并分析结果显示PSE组较脾切除术组住院治疗时间明显缩短(WMD=-2.52,95%CI:-3.36~-1.67,P<0001)。结论PSE组术后血小板前期升高较脾切除术组缓和,而远期并无明显区别;PSE组在对术后维持患者持免疫系统的储备功能、缩短住院时间、减少并发症等方面有明显优势。
【Abstract】:ObjectiveTo systematically evaluate the therapeutic effects of partial splenic embolization (PSE) and splenectomy for liver cirrhosis and hypersplenism. MethodsThe Medline, Embase, Web of Science, CNKI, Wanfang Data, and VIP were searched to collect the articles on PSE and splenectomy for liver cirrhosis and hypersplenism published between January 1, 2005 and May 30, 2015. The inclusion of articles was performed by two investigators independently, and after quality assessment and data extraction, RevMan 5.3 was applied for the Meta-analysis. ResultsA total of 10 control studies involving 638 patients were included. The results of the pooled analysis of 4 studies showed that the peripheral platelet counthad a significant difference between the PSE group and the splenectomy group at 1 week after surgery (WMD=-65.71, 95%CI:-120.24 to -11.18, P=0.02), but showed no significant difference at 1 month after surgery (WMD=068, 95%CI:-8.16-9.52, P=0.88). The results of the pooled analysis of 2 studies showed that at 1 month after surgery, the PSE group had a significantly higher number of natural killer cells than the splenectomy group (WMD=6.03, 95%CI: 3.80-8.26, P<0001), but there was no difference in this number at 1 year after surgery between the two groups (WMD=3.60, 95%CI:1.25-5.96, P=0.003). The results of the pooled analysis of 3 studies showed that the PSE group had a significantly shorter hospital stay than the splenectomy group (WMD=-2.52, 95%CI:-3.36 to -1.67, P<0.001). ConclusionCompared with the splenectomy group, the short-term increase in platelet count after surgery is alleviated in the PSE group, while there is no significant difference in long-term platelet count; PSE has significant advantages in maintaining the reserve function of immune system, shortening the length of hospital stay, and reducing complications in postoperative patients.
【关键字】:肝硬化;脾功能亢进;栓塞,治疗性;脾切除术;Meta分析
【Key words】:liver cirrhosis; hypersplenism; embolization, therapeutic; splenectomy; Meta-analysis
【引证本文】:何海冠, 沈艺南, 庞书杰,等. 脾切除术与部分脾动脉栓塞术治疗肝硬化脾功能亢进近期疗效比较的Meta分析[J]. 临床肝胆病杂志, 2016, 32(2): 301-306.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号