腹腔镜与开腹手术在治疗盆腔炎性包块围手术期的情况

目的:比较腹腔镜和开腹手术治疗盆腔炎性包块的围手术期情况,寻找一种合适的盆腔炎性包块治疗方法。方法:全面检索1997年1月～2010年8月Cochrane、Medline、EMbase、Springerlink、Highwire、CBM、CNKI、维普和万方等中英文数据库,获得有关腹腔镜和开腹手术治疗盆腔炎性包块的研究结果,对其进行方法学质量评价、筛选和异质性检验,要求所纳入的研究均为国内完成,对符合条件的所有研究结果进行汇总,计算手术时间、术后排气时间、体温恢复到正常时间、血象恢复时间、术中出血量以及住院时间各指标的加权均数差(WMD),并进行荟萃分析。结果:符合要求的4项随机对照临床研究入选共261例,上述临床试验的结果用Revman 4.2软件进行分析,结果显示腹腔镜治疗盆腔炎性包块组其手术时间少于开腹手术治疗盆腔炎性包块组(WMD为-39.57,95%CI为-61.15～-17.98);腹腔镜治疗盆腔炎性包块组术后排气时间早于开腹手术治疗盆腔炎性包块组(WMD为-19.04,95%CI为-25.53～-12.55);腹腔镜治疗盆腔炎性包块组体温恢复到正常时间早于开腹手术治疗盆腔炎性包块组(WMD为-42.63,95%CI为-51.26～-34.00);腹腔镜治疗盆腔炎性包块组血象恢复正常快于开腹手术治疗盆腔炎性包块组(WMD为-1.10,95%CI为-1.50～-0.70);腹腔镜治疗盆腔炎性包块组术中出血量少于开腹手术治疗盆腔炎性包块组(WMD为-249.02,95%CI为-249.02～-249.02);腹腔镜治疗盆腔炎性包块组住院时间明显少于开腹手术治疗盆腔炎性包块组(WMD为-5.80,95%CI为-7.80～-3.79)。结论:腹腔镜治疗盆腔炎性包块和开腹手术相比,手术时间短、术后体温以及血象恢复到正常水平快、住院时间短、术中出血量少,提示腹腔镜手术治疗盆腔炎性包块疗效优于开腹手术,可以作为盆腔炎性包块手术治疗的优先选择。

Analysis about the difference of laparoscopy surgery and open surgery in treating pelvic inflammation mass

Objective:To evaluate the difference in perioperative conditions of open surgery and laparoscopy surgery,in order to find a suitable treatment of pelvic inflammation mass.Methods:Articles of rigorous design researches about open surgery and laparoscopy surgery for treating pelvic inflammation mass published in China before August 2010 were retrieved,and correlated indexes such as hospitalized days,charges,diagnoses,operation and recovery status between two groups were extracted for meta analysis.Results:4 c...