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不同气腹压下腹腔镜胆囊切除术疗效的meta分析 被引量:9

Different insufflation pressures for laparoscopic cholecystectomy: a meta-analysis of randomized clinical trial
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摘要 目的评价腹腔镜胆囊切除术(Laparoscopic cholecystectomy,LC)过程中低压气腹(low-pressure pneumoperitoneum,LP)的安全性及有效性。方法本研究从MEDLINE、EMBASE、ISI数据库、CochraneLibrary、CBM、VIP、CNKI以及万方数据库检索并纳入了在1987年1月至2009年12月间发表的LP下LC的随机对照试验,语种不限,并对纳入研究的方法学质量进行评价,最后用RevMan 5.0软件进行分析。结果共纳入7个英文随机对照试验(randomized controlled trials,RCT),包括518例患者。与传统的标准气腹压(standard pneumoperitoneum,SP)下LC相比,LP下行LC明显减少术后肩痛发生率(RR为0.50,95%CI为0.37,0.68)、缩短住院时间(WMD为-0.13,95%CI为-0.23,-0.02);手术安全性评价上,LP组和SP组间的差异无统计学意义(RR为0.84,95%CI为0.46,1.54);两组的手术时间相当(WMD为1.54,95%CI为-0.85,3.76)。结论 LP下行LC是安全有效的,更具微创优势。 Objective To determine the efficacy and safety for low-pressure pneumoperitoneum(LP) in laparoscopic cholecystectomy(LC) from randomized controlled trials(RCTs).Methods A fully recursive literature search was conducted in Cochrane Library,MEDLINE,EMBASE,ISI databases and CBM,VIP,CNKI and Wan Fang database in any language.RCTs between Jan,1987 and Dec,2009 of LP in LC were considered for inclusion.Statistic analyses were carried out using RevMan 5.0 software.Results Five hundred and eighteen patients in 7 randomized controlled trials(RCTs) were included.The meta-analysis showed that incidence of shoulder tip pain was lower in the LP group(RR was 0.50,95% CI 0.37 to 0.68);length of postoperative days were shorter in the LP group(WMD was-0.13,95% CI-0.23 to-0.02);operative time and complications were similar in both groups(WMD was 1.54,95% CI-0.85 to 3.76;RR was 0.84,95% CI 0.46 to 1.54,respectively).Conclusions LP was more effective than SP in selective LC without increasing complications.
出处 《复旦学报(医学版)》 CAS CSCD 北大核心 2010年第6期724-728,共5页 Fudan University Journal of Medical Sciences
关键词 腹腔镜 胆囊切除术 气腹 META分析 laparoscopic cholecystectomy pneumoperitoneum meta-analysis
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参考文献18

  • 1Henny CP, Holland J. Laparoscopic surgery: pitfalls due to anesthesia, positioning, and pneumoperitoneum [J]. Surg Endosc,2005,19(9):1 163-1 171.
  • 2Alijani A, Hanna GB, Cuschieri At. Abdominal wall lift versus positive-pressure capnoperitoneum for laparoscopic cholecystectomy: randomized controlled trial[J]. Ann Surg ,2004,239(3) :388 - 394.
  • 3Galizia G, Prizio G, Lieto E, et al. Hemodynamic and pulmonary changes during open, carbon dioxide abdominal wall lifting cholecystectomy. A prospective, randomized study[J]. Surg Endosc,2001,15(15) :477-483.
  • 4Mertens zur Borg IR, Lira A, Verbrugge SJ, et al. Effect of intraabdominal pressure elevation and positioning on hemodynamic responses during carbon dioxide pneumoperitoneum for laparoscopic donor nephrectomy: a prospective controlled clinical study[J]. Surg Endosc ,2004,18(6) :919 - 923.
  • 5Giger UF,Michel JM, Opitz I, et al. Risk factors for perioperative complications in patients undergoing laparoscopie cholecystectomy:analysis of 22 953 consecutive cases from the Swiss association of laparoscopie and thoracoscopic surgery database [J]. J Am Coll Surg ,2006,203(5) :723 - 728.
  • 6Dexter SP, Vucevic M, Gibson J, et al. Hemodynamic consequences of high- and low-pressure eapnoperitoneum during laparoscopic cholecysteetomy[J]. Surg Endosc, 1999, 13(4) :376- 381.
  • 7Sarli L, Costi R, Sansebastiano G, et al. Prospective randomized trial of low-pressure pneumoperitoneum for reduction of shoulder-tip pain following laparoscopy[J]. Br J Surg,2000,87(9):l 161- 1 165.
  • 8张景华,曹月敏,谭文科,江建军,王兰辉,张万星,孟慧彦.不同压力CO_2气腹对腹腔镜胆囊切除术后肩部疼痛发病影响的临床观察[J].中华普通外科杂志,2004,19(4):214-216. 被引量:30
  • 9Wallace DH,Serpell MG, Baxter JN, et al. Randomized trial of different insufflation pressures for laparoscopic eholecystectomy[J]. BrJ Surg,1997,84(4):455 458.
  • 10Sefr R,Puszkailer K,Jagos F. Randomized trial of different intraabdominal pressures and acid-base balance alterations during laparoseopic cholecysteetomy[J]. Surg Endosc, 2003, 17(6) :947-950.

二级参考文献17

  • 1王光磊,刘功俭,齐敦益,曹君利.腹腔镜胆囊切除术二氧化碳气腹对呼吸功能的影响[J].南通医学院学报,2004,24(3):271-272. 被引量:5
  • 2张景华,曹月敏,谭文科,江建军,张万星,王兰辉.不同气腹压力下腹腔镜胆囊切除术气腹并发症的比较研究[J].中国微创外科杂志,2005,5(2):136-137. 被引量:25
  • 3刘建平,王小农,刘凤恩,何晓,段青,易坚,钟宝元,应勇,徐道峰.CO_2气腹压对老年人腹腔镜下胆囊切除术后恢复的影响[J].赣南医学院学报,2005,25(1):98-99. 被引量:2
  • 4[1]Cason CL,Seidel SL,Bushmiaer M. Recovery from laparoscopic cholecystectomy procedures[J].AORNF,1996,63:1099-1112
  • 5[2]Madsen MR,Jensen KEJ. Postoperative pain and nausea after laparoscopic cholecystectomy[J].Surg Laparosc Endosc,1992,2:303-305
  • 6[3]Wallace DH,Serpell MG,Baxter JN,et al.Randomized trial of different insufflation pressures for laparoscopic cholecystectomy[J].Br J Surg,1997,84:455-458
  • 7[4]Wills VL,Hunt DR.Pain after laparoscopic cholecystectomy[J].Br J Surg,2000,87:273-284
  • 8Lee IO,Kim SH,Kong MH,et al.Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine[].Canadian Journal of Anaesthesia.2001
  • 9Sarli R,Costi G,Sansebastiano M,et al.Prospective randomized trial of low -pressure pneumoperitoneums for reduction of shoulder -tip pain following laparoscopy[].British Journal of Surgery.2000
  • 10Madsen MR,Jensen KEJ.Postoperative pain and nausea after laparoscopic cholecystectomy[].Surgical Laparoscopy and Endoscopy.1992

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