Oyo-Ita Angela, Ugare Udey G, Ikpeme Ikpeme A
Department of Community Health, University of Calabar Teaching Hospital, Calabar, Nigeria.
Cochrane Database Syst Rev. 2012 Nov 14;11:CD007383. doi: 10.1002/14651858.CD007383.pub2.
Injury to the abdomen can be blunt or penetrating. Abdominal injury can damage internal organs such as the liver, spleen, kidneys, and intestine. There are controversies about the best approach to manage abdominal injuries.
To assess the effects of surgical and non-surgical interventions in the management of abdominal trauma.
We searched the Cochrane Injuries Group's Specialised Register, CENTRAL (The Cochrane Library 2012, issue 1), MEDLINE, PubMed, EMBASE, ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED), and ISI Web of Science: Conference Proceedings Citation Index-Science (CPCI-S) all until January 2012; CINAHL until January 2009. We also searched the reference lists of all eligible studies and the trial registers www.controlled-trials.com and www.clinicaltrials.gov in January 2012.
Randomised controlled trials of surgical and non surgical interventions among patients with abdominal injury who are haemodynamically stable and with no signs of peritonitis.
Two review authors independently applied the search criteria. One study involving participants with penetrating abdominal injury met the inclusion criteria. Data were extracted by two authors using a standard data extraction form.
One study including 51 participants with moderate risk of bias was included. Participants were randomised to surgery or an observation protocol. There were no deaths among the participants. Seven participants had complications; 5 (18.5%) in the surgical group and 2 (8.3%) in the non-surgical group; the difference was not statistically significant (p = 0.42; Fischer's exact). Among the 27 who had surgery six (22.2%) surgeries were negative laparotomies, and 15 (55.6%) were non-therapeutic.
AUTHORS' CONCLUSIONS: Based on the findings of one study involving 51 participants, which was at moderate risk of bias, there is no evidence to support the use of surgery over observation for people with abdominal trauma.
腹部损伤可分为钝性损伤和穿透性损伤。腹部损伤可能会损害肝脏、脾脏、肾脏和肠道等内部器官。关于处理腹部损伤的最佳方法存在争议。
评估手术和非手术干预措施在腹部创伤处理中的效果。
我们检索了Cochrane损伤组专业注册库、CENTRAL（《Cochrane图书馆》2012年第1期）、MEDLINE、PubMed、EMBASE、ISI科学网：科学引文索引扩展版（SCI-EXPANDED）以及ISI科学网：会议论文引文索引-科学版（CPCI-S），检索截至2012年1月；检索CINAHL截至2009年1月。我们还检索了所有符合条件研究的参考文献列表以及2012年1月的试验注册库www.controlled-trials.com和www.clinicaltrials.gov。
对血流动力学稳定且无腹膜炎体征的腹部损伤患者进行手术和非手术干预的随机对照试验。
两位综述作者独立应用检索标准。一项涉及穿透性腹部损伤参与者的研究符合纳入标准。由两位作者使用标准数据提取表提取数据。
纳入一项研究，共51名参与者，偏倚风险为中度。参与者被随机分为手术组或观察方案组。参与者中无死亡病例。7名参与者出现并发症；手术组5例（18.5%），非手术组2例（8.3%）；差异无统计学意义（p = 0.42；Fisher精确检验）。在接受手术的27例患者中，6例（22.2%）手术为阴性剖腹探查，15例（55.6%）为非治疗性手术。
基于一项涉及51名参与者、偏倚风险为中度的研究结果，没有证据支持对腹部创伤患者采用手术而非观察的方法。
