摘要
目的系统评价一次性切开根治术治疗肛周脓肿的临床疗效。方法通过计算机检索PubMed、Embase、Cochrane library、中国知网、万方数据和维普数据库中2010年1月1日~2020年12月31日所有关于一次性切开根治术治疗肛周脓肿的临床随机对照研究。由2名文献研究员分别对检出的文献进行筛选和评价,并提取出有效数据,运用Rev Man5.3对纳入文献进行Meta分析。结果共纳入16篇符合标准的文献,共计1867例患者进行Meta分析。同对照组相比,一次性切开根治术能提高临床治疗有效率[OR=4.21,95%CI(3.01~5.90);P<0.00001]、降低术后VAS疼痛评分[MD=-1.97,95%CI(-2.41~-1.52);P<0.00001]、保护肛门功能正常[OR=2.81,95%CI(1.75~4.49);P<0.0001]、缩短创面愈合时间[MD=-8.15,95%CI(-10.44~-5.86);P<0.00001]以及降低复发概率[OR=0.16,95%CI(0.09~0.29);P<0.00001]。结论一次性切开根治术对于肛周脓肿的治疗效果显著,提高了肛周脓肿患者治疗的临床有效率,值得临床推广应用。但本次研究存在文献质量偏低、样本量小等不足,需大样本、多中心的随机双盲文献提供临床依据。
Objective To systematically evaluate the clinical efficacy of one-time radical operation in the treatment of perianal abscess.Methods We searched PubMed,EMBASE,Cochrane Library,CNKI,Wanfang Data base and VIP database from January 1,2010 to December 31,2020 for all randomized controlled trials on the treatment of perianal abscess by one-time radical incision.Two literature researchers screened and evaluated the detected literatures,extracted effective data,and used Revman 5.3 to conduct meta-analysis on the included literatures.Results A total of 16 eligible articles and 1867 patients were included for meta-analysis.Compared with the control group,one-time open radical operation could improve the clinical treatment efficiency[OR=4.21,95%CI(3.01~5.90);P<0.00001],reduce the postoperative VAS pain score[MD=-1.97,95%CI(-2.41~-1.52);P<0.00001],protect the normal anal function[OR=2.81,95%CI(1.75~4.49);P<0.0001],and shorten the wound healing time[MD=-8.15,95%CI(-10.44~-5.86);P<0.00001]and reduced the recurrence rate[OR=0.16,95%CI(0.09~0.29);P<0.00001].Conclusion The curative effect of one-time radical operation for perianal abscess is significant,which improves the clinical efficiency of perianal abscess patients,and is worthy of clinical application.However,there are some shortcomings in this study,such as low quality of literature,small sample size and so on,large sample,multicenter randomized double-blind literature is needed to provide clinical basis.
作者
陈慧超
马珂珂
宫丹丹
王逸轩
章蓓
Chen Huichao;Ma Keke;Gong Dandan;Wang Yixuan;Zhang Bei(Nanjing Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China;Department of Anorectal,Nanjing Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210001,China)
出处
《中华结直肠疾病电子杂志》
2021年第4期385-391,共7页
Chinese Journal of Colorectal Diseases(Electronic Edition)
基金
国家中医药管理局全国名老中医药专家传承工作室支持项目(No.国中医药人教发[2011]41)。
