纤维蛋白粘合剂在胆囊切除术中疗效的Meta分析

目的评价纤维蛋白粘合剂在急性胆囊炎胆囊切除术中处理胆囊床的疗效。方法计算机检索中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库、数字化期刊全文数据库、PubMed、Cochrane Library、EMBASE、SCI等数据库并辅以手工检索，按照纳入和排除标准筛选并提取资料，采用Jadad评分标准评价纳入研究的质量，采用RevMan4．2软件进行统计学处理。结果纳入3篇文献（523例患者）。Meta分析结果显示：与电凝胆囊床相比，纤维蛋白粘合剂可缩短术后腹腔引流管留置时间（加权均数差-44．52，95％可信区间-50．87～-38．16），而在术后腹腔引流量（加权均数差-123．33，95％可信区间-338．29—91．63）、胆瘘发生率（优势比0．26，95％可信区间0．04～1．59）和膈下积液发生率（优势比0．19，95％可信区间0．02～1．68）等方面的差异无统计学意义。结论当前证据表明，纤维蛋白粘合剂可缩短术后腹腔引流管留置时间，而术后腹腔总引流量、胆瘘和膈下积液发牛率无差异。

Fibrin Tissue Adhesive for Cholecystectomy:A Meta-Analysis

Objective To systematically evaluate the effectiveness of fibrin tissue adhesive used in cholecystectomy for patients with acute cholecystitis. Method According to selection criteria, we searched randomized controlled trials or quasi-randomized controlled trials in PubMed, Cochrane Library, EMBASE, SCI, Chinese Biomedicine Database, WanFang Database Online, Chinese Scientific Journals Full-text Database, China Journal Full-text Database, quality assessment and data extraction were done by two reviewers independently according to the Jadad. Meta-analysis was performed as the results of homogenous studies by RevMan 4.2 software. Results We internalized three studies（about 523 patients）. The time that postoperates the drainage tube detained （P〈0.000 01） has statistical heterogeneity; the total amount that postoperates drained（P=0.26）, the incidence of biliary fistula（P=0.14）, and the incidence of fluid under disphragmatic muscle（P=0.14） have no statistical significance. Conclusion Fibrin tissue adhesive reduces the time postoperative drainage tube that was detained. The total amount postoperate drained, the incidence of biliary fistula, and the incidence of fluidify under disphragmatic muscley were of no difference. More trials of high quality are required.