国内食物不耐受饮食干预效果的Meta分析

目的 用Meta分析评价国内食物不耐受的饮食干预对临床症状的改善效果.方法 搜索国内的相关随机对照试验,用Jadad计分法质量评价文献质量,资料分析提取后采用Rev-man5.0软件进行数据分析.结果 检测到符合要求的文献研究6篇,Meta分析显示合并分析的饮食干预对临床症状干预效果有统计学意义.结论 对国内食物不耐受患者进行饮食干预后临床症状有显著改善.建议进行大样本、高质量的临床研究,提供更佳的循证证据.

Clinical outcomes of transperitoneal laparoscopic adrenalectomy for large adrenal tumors

Objective To evaluate technical feasibility, safety and clinical outcomes of transperitoneal laparoscopic adre- nalectomy （TPLA） for large adrenal tumors for various adrenal disorders by transperitoneal approach. Methods The data of 38 patients who underwent laparoseopic adrenaleetomy for adrenal masses ≥6.0 cm between July 2006 and October 2012 were ana- lyzed for this study. Results All laparoscopie adrenalectomy were successfully completed transperitonealy, none needed conver- sion to open surgery. Estimated blood loss was 20 ml -30Oral（ average 80ml）. The mean operative time was 100 minutes （ranged 90 - 180 minutes）. Patients usually passed gas 1 - 2 days postoperatively , early ambulation occurred within 2 days after surgery, postoperative hospital stay ranged 3 to 7 days. No major postoperative complications were noted. Conclusion Laparoscopic adre- nalectomy by lateral transperitoneal approach might be a safe and efficient mean of resecting large （ ≥6 cm） adrenal tumors. The advantages of TPLA include a large working space, excellent view, easy orientation , early ligation of the adrenal vein and fitting the ergonomical needs and this approach could be suitable for resection of large adrenal tumors.