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腹腔镜脾切除术与开腹脾切除术治疗特发性血小板减少性紫癜的临床疗效比较：Meta 分析。

Comparison of clinical efficacy of laparoscopic splenectomy versus open splenectomy for idiopathic thrombocytopenic purpura: A meta-analysis.

机构信息

Department of General Surgery, Hangzhou Normal University Affiliated Hospital, Hangzhou, China.

出版信息

Medicine (Baltimore). 2021 Jan 29;100(4):e24436. doi: 10.1097/MD.0000000000024436.

DOI:10.1097/MD.0000000000024436
PMID:33530246
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7850653/
Abstract

BACKGROUND

The purpose of this study is to compare the clinical efficacy of laparoscopic splenectomy (LS) and open splenectomy (OS) in the treatment of Idiopathic thrombocytopenic purpura.

METHODS

We systematically searched PubMed, Web of science, EMBASE, Clinicaltrials.gov, and Cochrane Central Register for studies (study published from July 1992-January 2020). This study analyzed the clinical effect of LS and OS on idiopathic thrombocytopenic purpur.

RESULTS

This study showed that compared with OS, the LS's Overall response (OR: 0.60, 95% confidence interval (CI): 0.23-1.59, P = .30), Complication (OR: 0.59, 95% CI: 0.18-1.94, P = .38), Accessory spleen(OR: 1.70, 95% CI: 0.98-2.98, P = .06), Wound infections (OR: 0.65, 95% CI: 0.26-1.59, P = .34), Pancreatic fistula (OR: 0.73, 95% CI: 0.16-3.30, P = .68), was no significant, the Operative time (weighted mean difference (WMD): 49.33, 95% CI: 36.29-62.37, P < .00001)was longer, and the Estimated blood loss (WMD: -172.59, 95% CI: -319.96 to -25.22, P = .02), Postoperative length of stay (WMD: -4.68, 95% CI: -7.75 to -1.62, P = .003)was less.

CONCLUSIONS

The therapeutic effect of LS was the same as that of OS in Overall response Complication Accessory spleen, while The operative time was longer, the Estimated blood loss was less, and the postoperative length of stay was shorter.

摘要

背景

本研究旨在比较腹腔镜脾切除术（LS）和开放性脾切除术（OS）治疗特发性血小板减少性紫癜的临床疗效。

方法

我们系统地检索了 PubMed、Web of Science、EMBASE、Clinicaltrials.gov 和 Cochrane 中心对照试验注册库（研究发表于 1992 年 7 月至 2020 年 1 月）。本研究分析了 LS 和 OS 治疗特发性血小板减少性紫癜的临床效果。

结果

本研究表明，与 OS 相比，LS 的总体反应率（OR：0.60，95%置信区间（CI）：0.23-1.59，P=0.30）、并发症（OR：0.59，95%CI：0.18-1.94，P=0.38）、副脾（OR：1.70，95%CI：0.98-2.98，P=0.06）、切口感染（OR：0.65，95%CI：0.26-1.59，P=0.34）、胰瘘（OR：0.73，95%CI：0.16-3.30，P=0.68）无显著差异，手术时间（加权均数差（WMD）：49.33，95%CI：36.29-62.37，P<0.00001）较长，估计失血量（WMD：-172.59，95%CI：-319.96 至-25.22，P=0.02）、术后住院时间（WMD：-4.68，95%CI：-7.75 至-1.62，P=0.003）较短。

结论

LS 的治疗效果与 OS 相同，在总体反应、并发症、副脾方面，而手术时间较长，估计出血量较少，术后住院时间较短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/5bbe27327bae/medi-100-e24436-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/e8d77e11969f/medi-100-e24436-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/f89b0a0f09bd/medi-100-e24436-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/a1ff0a7615d9/medi-100-e24436-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/a38a7cf708e7/medi-100-e24436-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/6197484a7e2d/medi-100-e24436-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/d7cad186badc/medi-100-e24436-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/5bbe27327bae/medi-100-e24436-g009.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/6db52391922f/medi-100-e24436-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/a1ff0a7615d9/medi-100-e24436-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/a38a7cf708e7/medi-100-e24436-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/6197484a7e2d/medi-100-e24436-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/d7cad186badc/medi-100-e24436-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528b/7850653/5bbe27327bae/medi-100-e24436-g009.jpg

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