腹腔镜胆总管切开取石术一期缝合的Meta分析-临床医学;普通外科专业论文.docxVIP

汕头大学医学院 汕头大学医学院 2004 级本硕连读硕士研究生学位论文 ~IV~ ~IV~ 腹腔镜胆总管切开取石术一期缝合的Meta分析 硕士研究生：王锦祥 1 导 师：周晓初 2 主任医师 1、汕头大学医学院 2004 级本硕连读临床硕士研究生 汕头 515031 2、深圳市中医院 深圳 518033 中 文 摘 要 目的 系统评价腹腔镜胆总管切开取石术一期缝合的临床效果，为临床提供参考。 方法 全面搜索国内外关于腹腔镜胆总管切开取石术一期缝合与留置 T 管的随机对照研 究。按照既定的纳入、排除标准，核定检出符合评价标准的文献，提取所需研究数据，采 用 RevMan4.2 软件进行 Meta 分析。 结果 纳入的随机对照研究 12 篇，共计 1204 例腹腔镜胆总管切开取石术。Meta 分析结 果显示，与常规留置 T 管相比，一期缝合胆总管在手术时间、手术后住院时间、手术近期 并发症发生率上差异有显著性（P0.01、P0.01 和 P0.01）；而在术后远期并发症发生率 上无差异性（P0.05）。 结论 在严格掌握适应证的前提下腹腔镜胆总管切开取石术采用一期缝合是安全可行 的，可推广应用。一期缝合不但可以缩短手术时间、术后住院时间，还可以降低术后近期 并发症的发生率和避免由留置 T 管所带来的潜在并发症 关键词 腹腔镜胆总管切开取石术；一期缝合；T 管引流；Meta 分析 ~V~ ~V~ A mate-analysis of primary closure versus routine T-tube drainage in Laparoscopic Choledocholithotomy Jin-xiangMaster Graduate: Wang 1 Jin-xiang Advisor: Zhou Xiao-chu2 Senior Doctor 1. Master graduate in grade 2004, Medical College of Shantou University, Shantou 515031 2.Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033 English Abstract Objective：To evaluate randomized controlled trials(RCTs) of clinical research of primary closure versus routine T-tube drainage in laparoscopic choledocholithotomy(LCD) and provide scientific basis by systematic review for clinical research. Methods: Studies on comparison between primary closure and routine T-tube drainage in laparoscopic choledocholithotomy were identified. All the randomized controlled trials were included for Meta analysis with Rev Man 4.2 software. Results: Twelve eligible randomized controlled trials showed 1204 LCD. The result of meta-analysis indicated that it had significant difference in the risk of recent complications and operative time and post-operative staying time in hospital by comparison between primary closure and T-tube drainage （P0.01,P0.01,P0.01）.Primary closure decreases the chance of recent complications and shortens both the operative time and the post-operative staying time in hospital greatly. But the risk of long-term complications had no significant differ