穿刺抽气与胸腔闭式引流术治疗原发性自发性气胸的Meta分析

Meta-Analysis of Needle Aspiration Versus Chest Tube Drainage in Primary Spontaneous Pneumothorax

目的评价穿刺抽气与胸腔闭式引流术用于治疗原发性自发性气胸(PSP)的有效性及安全性。方法通过搜索PubMed、Cochrane图书馆、Ovid、EMBase、中国生物医学文献光盘数据、中文科技期刊全文数据库、CNKI数据库,筛选出1991年1月—2011年1月有关穿刺抽气术与胸腔闭式引流术治疗PSP的随机对照试验,并用RevMan 5.0进行Meta分析。结果共纳入文献5篇,383例患者。Meta分析显示:两种方法对于治疗PSP的总的治愈率、3个月内复发率、6个月内复发率、1年内复发率、2年内复发率,两组间差异均无统计学意义(P>0.05);但穿刺抽气组术后住院时间要显著短于胸腔闭式引流组(P<0.05)。结论穿刺抽气术对于治疗PSP优势明显,可作为临床治疗的首选方式。

Objective To assess the efficacy and safety of needle aspiration versus chest tube drainage in the treatment of primary spontaneous pneumothorax（PSP）.Methods PubMed,Cochrane Library,Ovid,EMBase,CBM,VIP and CNKI were searched to collect randomized controlled trials about needle aspiration and chest tube drainage in the treatment of primary spontaneous pneumothorax from January 1991 to January 2011.The quality of included trials was assessed.Data were extracted and analyzed with RevMan 5.0 software.Results After Screening 5 studies were brought into the review including 383 patients.There was no statistically significant differences in success rate,3-month recurrence,6-month recurrence,1-year recurrence,2-year recurrence between needle aspiration and chest tube drainage（P0.05）.Patients treated by needle aspiration had a shorter duration of hospital stay.Conclusion Needle aspiration is much more superior in the treatment of primary spontaneous pneumothorax and can be taken as the first choice clinically.