内镜下逆行阑尾炎治疗术治疗急性非复杂性阑尾炎疗效的Meta分析

目的评价内镜下逆行阑尾炎治疗术治疗急性非复杂性阑尾炎的临床价值。方法通过计算机检索PUBMED、CNKI数据库、Web of Knowledge、Cochrane图书馆对照试验注册库和万方数据库从建库至2018年6月的有关内镜下逆行阑尾炎治疗术治疗急性非复杂性阑尾炎的相关文献,采用Cochrane协作网提供的Rev Man 5.0版软件进行统计处理,对纳入资料的异质性进行分析,计算O^R值或MD值及其95%可信区间(95%CI)。结果按照入选标准,纳入了8项临床试验,共537例患者。Meta分析结果显示,内镜下逆行阑尾炎治疗术治疗急性非复杂性阑尾炎住院时间短(MD=-2.11,95%CI:-3.10～-1.11,P 0.05)、并发症发生率低(O^R=0.27,95%CI:0.13～0.56,P 0.05)、手术时间短(MD=-23.46,95%CI:-29.97～-16.96,P 0.05)。结论目前的研究结果显示,内镜下逆行阑尾炎治疗术是一种安全有效地治疗急性非复杂性阑尾炎的内镜治疗方法,可有效缩短患者的手术时间、住院时间和降低并发症发生率,具有临床推广及应用价值。

Effect of endoscopic retrograde appendicitis therapy in treating patients with uncomplicated acute appendicitis: a Meta-analysis

To evaluate the clinical value of endoscopic retrograde appendicitis therapy in the treatment of uncomplicated acute appendicitis. Methods The literature on endoscopic retrograde appendicitis therapy in treating patients with uncomplicated acute appendicitis was retrieved combined with manual retrieval from PUBMED, China national knowledge infrastructure (CNKI), Web of Knowledge, the Cochrane controlled trials register library repository, Wanfang Database published between inception and June 2018 in China. RevMan 5.0 software from Cochrane cooperation network was used for data analysis. Pooled odds ratio (OR) or Mean difference (MD) and 95% confidence intervals (95%CI) were calculated and the heterogeneity was also assessed. Results According to the selection criteria, 8 clinical trials with five hundred and thirty seven patients were selected finally. The combined results of meta-analysis showed that compared with traditional method, endoscopic retrograde appendicitis therapy had shorter hospital stay (MD = -2.11, 95%CI: -3.10 ~ -1.11, P < 0.05), low complication rate (OR = 0.27, 95%CI: 0.13 ~ 0.56, P < 0.05), shorter operative time (MD = -23.46, 95%CI: -29.97 ~ -16.96, P < 0.05). Conclusion Our study indicates that endoscopic retrograde appendicitis therapy in treating patients with uncomplicated acute appendicitis is safety and efficacy. It has the advantages of shorter hospital stay, low complication rate, shorter operative time, and which is worthy of clinical promotion and application.