十二指肠憩室手术疗效的Meta分析

目的 评价十二指肠憩室各种术式的疗效.方法 检索<中国期刊全文数据库(CJFD)>2000年1月至2006年8月国内公开发行的关于十二指肠憩室的文章,对各种术式术后症状缓解率、并发症发生率等数据进行Meta分析.各种术式疗效之间的差异采用χ~2检验分析.结果 在症状缓解率方面,Billroth Ⅱ式胃大部切除术、胃空肠Roux-en-Y吻合术等胃肠转流术式与憩室切除术、憩室内翻缝合术、Oddi括约肌切开成形术比较差异有统计学意义(χ~2=21.269,4.285,12.914,19.266,3.938,P<0.05);在并发症发生率方面,Billroth Ⅱ式胃大部切除术、胃空肠Roux-en-Y吻合术与憩室切除术、憩室内翻缝合术比较差异有统计学意义(χ~2=4.164,9.166,7.926,4.659,4.858,P<0.05).结论 对于症状明显并经长期内科治疗无效的十二指肠憩室炎及其并发症,经不同的术式均可获得满意的疗效,尤以Billroth Ⅱ式胃大部切除术或胃空肠Roux-en-Y吻合的憩室旷置术安全,并发症少,预后良好.

Meta-analysis of curative effect of operations for duodenal diverticulum

Objective To evaluate the curative effect of different operative methods for duodenal diverticulum. Methods Articles of operations for duodenal diverticulum that were published between January 2000 to August 2006 were retrieved from China Journal Full-text Database, and the symptom remission rate and complication rate were underwent Meta-analysis. All data were analyzed by chi-square test. Results There was significant difference in symptom remission rate between Billroth Ⅱ subtotal gastrectomy, Roux-en-Y gastrojejunostomy and diverticulectomy, diverticulum inverting suture, sphincteroplasty of Oddi (χ~2= 21.269, 4.285, 12.914, 19.266, 3.938, P < 0.05). The difference in complication rate between Billroth Ⅱ subtotal gastrectomy, Roux-en-Y gastrojejunostomy and diverticulectomy, diverticulum inverting suture reached statistical significance (χ~2 =4.164, 9.166, 7.926,4.659, 4.858, P < 0.05). Conclusion For duodenal diverticulitis and the related complications which can not be effectively managed by internal medical treatment and with obvious symptom, Billroth Ⅱ subtotal gastrectomy and Roux-en-Y gastrojejunostumy are safe and effective.