摘要
目的:通过采用Meta分析方法评价内镜微创保胆取石术后应用牛磺熊去氧胆酸治疗胆囊结石复发的有效性及安全性,为牛磺熊去氧胆酸结合内镜微创保胆取石术治疗胆囊结石提供依据。方法:全面检索中国知网数据库、万方数据库、维普中文期刊数据库、Pubmed、Cochrane Library、Web of science,收集应用牛磺熊去氧胆酸结合内镜微创保胆取石术治疗胆囊结石的随机对照试验(RCT)文献,检索时间截止至2019年12月。对符合纳入标准的文献进行质量评价与数据提取,并采用stata14.0进行Meta分析。结果:共检索且符合纳入标准的文献7篇RCT研究,共1207例患者。其中牛磺熊去氧胆酸组633例,对照组574例。Meta分析结果显示:与对照组比较,术后服用牛磺熊去氧胆酸可以缩减胆囊壁厚度[WMD=–0.817,95%CI(–1.400,–0.234),P=0.006];改善胆囊收缩功能[WMD=19.099,95%CI(16.256,21.941),P<0.00];减少胆石症状的复发[RR=0.338,95%CI(0.120,0.954),P=0.040];降低胆囊结石的复发[RR=0.230,95%CI(0.145,0.365),P<0.001],差异均有统计学意义。结论:内镜微创保胆取石术后应用牛磺熊去氧胆酸具有预防胆囊结石复发的作用。
Objective To evaluate the efficacy of Tauroursodeoxycholic acid in treating the recurrence of cholecystolithiasis after choledochoscopic gallbladder-preserving cholecystolithotomy through a system review and Meta-analysis,which in order to provide the evidence for the treatment of cholecystolithiasis by the combination of Tauroursodeoxycholic acid and choledochoscopic gallbladder-preserving cholecystolithotomy.Methods The randomized trials were located through searches of variety of databases,such as China National Knowledge Infrastructure Database,Wanfang Database,VIP Database,Pubmed,Cochrane Library,Web of Science.The deadline of the search is December 2019.The literature met the inclusion criteria for quality evaluation and data extraction.Software stata 14.0 was used for Meta-analysis.Results A total of 7 trials involving 1207 patients were included.The number of Tauroursodeoxycholic acid group and control group was 633 and 574 respectively.The Meta-analysis showed that compared with control group,application of Tauroursodeoxycholic acid could curtail the thickness of the gallbladder wall[WMD=-0.817,95%CI(-1.400,-0.234),P=0.006],improve gallbladder contractile function[WMD=19.099,95%CI(16.256,21.941),P<0.000],decrease the recurrence of gallstone symptoms[RR=0.338,95%Cl(0.120,0.954),P=0.040]and reduce the recurrence of cholecystolithiasis[RR=0.230,95%CI(0.145,0.365),P<0.001].The difference was statistically significant(P<0.05).Conclusion After choledochoscopic gallbladder-preserving cholecystolithotomy,the application of Tauroursodeoxycholic acid in the treatment of recurrence of gallbladder stones has clear preventive effect.These conclusions needed to be validated by more high-quality studies.
作者
胡英男
傅永清
万勇
赵启明
华林
徐菁铭
黄捷
HU Ying-nan;FU Yongqing;WAN Yong(Zhejiang Chinese Medical University,Hangzhou,Zhejiang,(310051),China)
出处
《中国中西医结合外科杂志》
CAS
2020年第5期973-979,共7页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
