部分脾动脉栓塞术对比脾切除术治疗肝硬化脾功能亢进的Meta分析

目的 系统评价部分脾动脉栓塞术(partial splenic artery embolization,PSE)与脾切除术治疗肝硬化脾功能亢进的疗效。方法 通过检索PubMed、Cochrane Library、Embase、中国知网、万方数据知识服务平台等数据库,收集自建库以来至2021年10月30日关于PSE与脾切除术治疗肝硬化脾功能亢进的随机对照试验和队列研究,由两位研究员分别独立筛选文献、提取资料和评价偏倚风险后进行统计分析。结果 共纳入14篇文献,1092例患者,Meta分析结果显示,两组术后1周、1个月、1年白细胞计数水平比较,差异均无统计学意义(P＞0.05),术后6个月(MD= -2.03,95%CI:-3.03~-1.04,P＜0.001)脾切除术组明显高于PSE组；两组术后1个月、1年血小板计数比较,差异无统计学意义(P＞0.05)；术后1周(MD=-65.46,95%CI:-116.39~-14.52,P=0.01)和术后6个月(MD= -117.99,95%CI:-229.71~-6.27,P=0.04)脾切除术组均高于PSE组；两组术后1周、1个月和1年红细胞计数水平比较,差异均无统计学意义；两组患者NK细胞计数水平比较,术后1个月(MD= 6.02,95%CI:4.27~7.77,P<0.001)、术后1年(MD=3.53,95%CI:1.68~5.37,P=0.0002),均提示PSE组的术后自然杀伤细胞计数水平明显高于脾切组；与脾切除术组比较,PSE组术中出血量更少(MD=-73.92,95%CI:-89.39~-58.45,P<0.001)、住院费用更少(MD=-0.80,95%CI:-1.27~-0.34,P=0.0008)、住院时间也更短(MD=-4.08,95%CI:-5.22~-2.95,P<0.001)。结论 现有证据表明,PSE治疗肝硬化脾功能亢进短期与远期均有一定的疗效,相较于脾切除术,其手术创伤小,住院时间和费用少,并发症易控制,且可保留一定的免疫功能,更值得在临床应用推广。受纳入文献数量以及质量的限制,上述结论仍需开展更多高质量研究予以验证。

Informatization Management and Practical Exploration of Information Technology Laboratories in Universities and Colleges of Traditional Chinese Medicine

Purpose/Significance To provide reference for the information technology laboratory management in universities and colleges of traditional Chinese medicine(TCM). Method/Process The paper focuses on the main problems faced by information technology laboratory management in universities and colleges of TCM, and proposes ideas of informatization path selection based on practices in Hubei University of Chinese Medicine.It constructs informatization management system from the following aspects:network foundation of information technology laboratory, terminal protection cloud service, internet of things technology application, laboratory opening, experimental teaching resource sharing, etc. Result/Conclusion The informatization management system significantly improves the utilization rate of the laboratory, greatly reduces the personnel cost and time cost.