防粘连措施预防术后盆腹腔粘连有效性及安全性的meta分析

目的:系统评价生物可吸收防粘连膜预防术后盆腹腔粘连的有效性及安全性。方法:计算机全面检索Pub Med数据库、Spring数据库、OVID数据库、CBM数据库、CNKI数据库、万方数据库,查找关于生物可吸收防粘连膜(HC-CMC)预防术后盆腹腔粘连的有效性及安全性的随机对照文献,检索时限2000年2月至2015年3月。按纳入和排除标准进行文献筛选、资料提取和质量评价后,采用Rev Man 5.3软件进行Meta分析。结果:最终共纳入7篇RCT文章。Meta分析结果显示,试验组与对照组的术后盆腹腔粘连、粘连严重程度2级和3级、粘连范围2级和3级的发生率比较,差异均有统计学意义;粘连严重程度1级和粘连范围1级的发生率比较,差异均无统计学意义(P=0.82,P=0.1)。试验组与对照组的术中出血量比较,差异有统计学意义(P0.00001);而术后肠梗阻、盆腹腔脓肿、伤口感染、高热的发生率比较,差异均无统计学意义。结论:手术中应用生物可吸收防粘连膜可降低盆腹腔粘连的发生率,减轻粘连严重程度,减少粘连范围,减少术中出血量,然而术后肠梗阻、盆腹腔脓肿、伤口感染及术后高热的发生率相似。

Clinical efficacy and safety of adhesion prevention measures in preventing postoperative abdominopelvic adhesions:a Meta-analysis

Objective:To assess the clinical effectiveness and safety of biological ad-sorbable anti adhesion membrane in preventing postoperative abdominopelvic adhesions. Meth-ods:The following databases such as PubMed、Spring、OVID、CBM、CNKI、Wanfang data were searched to collect the randomized control trails ( RCTs ) about the clinical effectiveness and safety of biological adsorbable anti adhesion membrane ( HC-CMC ) in preventing postoperative abdominopelvic adhesions. According to the inclusion and exclusion criteria to search studies, extracted data,and evaluated the methodological quality. The meta-analysis was performed using RevMan software version 5. 3. Results:Seven RCTs were included. In the aspect of validity,me-ta-analyses showed that compared with the control gruop,The incidence of adhesions have sta-tistical significance(P<0. 00001). The incidence of adhesions degree level2,level3 have statis-tical significance. The incidence of adhesions degree level 1 have no statistical significance( P=0. 82). The incidence of adhesions scope level 2,level 3 have statistical significance. The inci-dence of adhesions scope level 1 have no statistical significance ( P=0 . 1 ) . Meta-analyses showed that compared with the control gruop,the intraoperatve blood loss have statistical signifi-cance(P<0. 00001). Postoperative intestinal obstruction,abdominal abscess,the incidence of wound infection,high fever were not statistically significant. Conclusion:Application of adsorb-able anti adhesion membrane in the operation can reduce the incidence of abdominopelvic adhe-sion,reduce the degree of adhesion, reduce the scope of adhesion, reduce the intraoperatve blood loss. But the abdominal abscess,intestinal obstruction,wound infection and the incidence of postoperative adverse reaction such as high fever is similar.