两种引流方法治疗结核性胸膜炎临床疗效的Meta分析

目的 系统评价中心静脉导管胸腔闭式引流术与反复胸腔穿刺抽液术两种方法治疗结核性胸膜炎的临床疗效。方法 计算机检索Medline、Pubmed、万方、中国知网、维普等数据库等关于两种引流方法治疗结核性胸腔积液的临床疗效比较的随机对照试验，由两位研究者按照纳入和排除标准独立筛选文献、提取资料并进行质量评价，并使用RevMan 5.2软件进行Meta分析。结果 共纳入14篇符合条件文献1234例结核性胸膜炎患者。Meta分析结果显示，经中心静脉持续胸腔闭式引流术治疗的治疗组的临床疗效优于反复胸腔穿刺抽液术治疗的对照组（OR=6.09，95% CI：3.71~9.99，P=0.000），可明显缩短胸腔积液消失时间（MD=-7.49，95% CI：-8.86~-6.12，P=0.000），并在防止胸膜肥厚方面明显优于对照组（OR=0.28，95% CI：0.17~0.47，P=0.000）。结论 在有效抗结核治疗前提下，中心静脉导管胸腔闭式引流术治疗结核性胸膜炎的临床疗效优于反复胸腔抽液术，不仅明显缩短了胸腔积液消失时间，还能降低胸膜肥厚的发生，具有更好的临床应用价值。

Meta Analysis of the Therapeutic Effect of Two Drainage Technique in Drawing Fluid from Tubercular Pleurisy Patients

Objective To evaluate the clinical therapeutic efficacy of central venuous chest-closed drainage technique and traditional chest cacity drainage technique in drawing fluid from tubercular pleurisy patients with Meta analysis method. Methods The databases of Medline,PubMed, Wanfang Database, CNKI and VIP Database are retrieved with computer for searching the randomized controlled trials (RCT)about treatment of two drainage technique in drawing fluid from tubercular pleurisy patients. Two reviewers independently screened literature according to inclusion criteria and exclusion criteria, evaluated quality, and extracted data. The data was given a Meta-analysis by using Review Manager 5.2 software. Results There are totally 9 RCTs included involving 742 tubercular pleurisy patients.The results showed that the total effective rate of the central venuous chest-closed drainage technique group (treatment group)was significantly higher than traditional chest cacity drainage technique (control group) (OR=6.09,95% CI:3.71~9.99,P=0.000),the time of pleural effusion absorption of the treatment group were significantlu shorter than the control group (MD=-7.49,95% CI:-8.86~-6.12,P=0.000),and the treatment group can reduce the probability of pleural incrassation incidence (OR=0.28,95% CI:0.17~0.47,P=0.000). Conclusion On the basis of effective antituberculosis therapy,it is feasible and safe to drain pleural effusion by using central venuous chest-closed drainage technique,which can shorter pleural effusion absorption time,also can reduce the pleura incrassation incidence,thus is worthy of application in clinical.