国内腹腔镜与经腹子宫切除术相关随机对照试验的系统评价

Laparoscopic and Abdomioal Hysterectomy:Systematic Evaluation and Meta-analysis of Randomized Controlled Trials

目的:比较腹腔镜子宫切除术和经腹子宫切除术的安全性和可行性差异。方法:计算机检索电子数据库,手工检索相关杂志。由两名评价员独立检索和提取资料并交叉核对,纳入高质量随机对照试验。Meta分析软件是Cochrane协作网提供的RevMan 5.0。结果:共纳入高质量的RCT试验9个,包括1290例患者,其中腹腔镜手术组664例,经腹手术组626例。Meta分析结果显示:两组间手术时间差异无统计学意义[MD2.02,95%CI(-4.41,8.45);P=0.54];两组间术中出血量、术后住院时间、术后排气时间、术后病率、术后镇痛用药率、术后血红蛋白量、伤口愈合时间、疼痛强度及术后离床活动时间等指标,腹腔镜子宫切除术均优于经腹子宫切除术。结论:腹腔镜子宫切除术安全性、可行性及优越性均优于经腹子宫切除术。

Objective：To evaluate the efficacy, safety and feasibility of laperoscopic and abdominal hysterectomy. Methods：Electronic database was searched by computer, magazine was searched by manual. Independent search, abstraction of data and cross check were done by two evaluated persons, which was enrolled in high quality randomized controlled trials （RCT）. Meta-analysis software was RevMan4.5 provided by Cochrane collaboration net. Resuits：9 trials （total of 1290 participants） were included in high quality RCT trial, and there were 664 cases in laparoscopic hysterectomy, 626 cases in abdominal hysterectomy. Meta analysis results showed that there was no statistic significance in operation time[ MD 2.02,95%C1（ - 4.41,8.45） ; P= 0.54]. The volume of blood loose during operation, time of hospitalization after operation, time of passage of gas by anus, postoperative morbidity, medication rate of analgesia after operation, hemoglobin value after operation, cure time, pain intensity and ambulation time after operation in laparoscopic group were better than these in abdominal hysterectomy. Conclusions： Laparoscopic hysterectomy may be better than abdominal hysterectomy in efficacy, safety and feasibility.