医用生物蛋白胶在甲状腺手术中应用的 Meta分析简

背景：医用生物蛋白胶具有封闭组织创面、减少渗出、止血、促进伤口愈合和防止粘连等功能。目的：系统评价医用生物蛋白胶在甲状腺手术中应用的效果。 方法：应用计算机检索中国期刊网全文数据库、万方数据库、维普数据库、中国生物医学数据库网络版2000年1月至2013年4月公开发表的医用生物蛋白胶在甲状腺手术中应用的随机对照临床试验文献，对纳入的研究采用Rev Man 5.2统计学软件进行Meta分析。 结果与结论：共纳入6项研究，合计797例患者。Meta分析结果显示，使用医用生物蛋白胶组术后第1天引流量[比值比为-27.36，95%可信区间（-33.86，-20.87），P〈0.00001]和术后总引流管引流量[加权均数差为-38.73，95%可信区间（-44.78，-32.67），P 〈0.00001]低于未使用医用生物蛋白胶组，术后切口拆线时间短于未使用医用生物蛋白胶组[比值比为-2.00，95%可信区间（-2.17，-1.83），P 〈0.00001]。两组术后3 d发热[比值比为1.53，95%可信区间（0.59，3.96），P=0.38]、切口感染[比值比为0.86，95%可信区间（0.12，6.15），P=0.88]及术后血肿[比值比为0.86，95%可信区间（0.21，3.48），P=0.83]等并发症无差异。说明在甲状腺手术应用医用生物蛋白胶在不增加术后并发症的情况下，可明显减少引流液的量。

Meta-analysis of fibrin glue used in thyroid surgery

BACKGROUND：Fibrin glue can function to close the wound tissue, reduce leakage, stop bleeding, promote wound healing and prevent adhesion. OBJECTIVE：To systematicaly review the application of fibrin glue in thyroid surgery. METHODS：We searched China Journal Net database, Wanfang database, VIP database, Chinese Biomedical Database Online to retrieve clinical randomized controled trials related to fibrin glue applied in thyroid surgery from January 2000 to April 2013. Included studies were analyzed using Rev Man 5.2 statistical software for Meta-analysis. RESULTS AND CONCLUSION：A total of six studies including 797 cases were enroled in result analysis. Meta-analysis showed that the drainage volume at postoperative day 1 and total postoperative drainage volume were higher in the fibrin glue group than the control group （without fibrin glue） [odds ratio=-27.36, 95% confidence interval （-33.86,-20.87）,P 〈 0.00001; weighted mean difference=-38.73, 95% confidence interval （-44.78,-32.67）,P 〈 0.000 01]. The suture removal time was shorter in the fibrin glue group than the control group [odds ratio=-2.00, 95% confidence interval （-2.17,-1.83）,P 〈 0.000 01]. No significant difference was found in the postoperative 3-day fever incidence [odds ratio=1.53, 95% confidence interval （0.59,3.96）,P=0.38], wound infection [odds ratio=0.86, 95% confidence interval （0.12, 6.15）,P=0.88], and postoperative hematoma [odds ratio=0.86, 95% confidence interval （0.21, 3.48）,P=0.83] between the two groups. These findings indicate that fibrin glue used in thyroid surgery can significantly reduce drainage by non-increasing postoperative＆nbsp;complications.