摘要
目的:通过循证医学的方法来探讨慢性胰腺炎(chronic pancreatitis,CP)手术治疗和内镜治疗的疗效比较.方法:计算机检索在2013-12-31前在Medline、EMBASE、Science Direct、Springer link、CBM、中国知网、万方以及维普数据库公开发关于CP手术和内镜治疗疗效比较的文献,按纳入排除标准由2位研究者独立进行文献筛选、资料提取和方法学质量评价后,采用RevMan 5.2.7软件进行Meta分析.结果:共纳入5篇研究,其中包含4篇英文文献1篇中文文献,共包含CP患者393例,Meta分析结果显示:手术组术后的疼痛的总体缓解率以及完全缓解率高于内镜组,两组的差异具有统计学意义(P<0.05),而手术组和内镜组术后的疼痛的局部缓解率(术后症状减轻)的差异无统计学意义(P>0.05),手术组和内镜组的随访1、3、5年的糖尿病发生率、并发症的发生率、术后远期的胰腺内外分泌功能的障碍的差异无统计学意义(P>0.05).结论:外科手术术后的远期生存质量高于内镜组,但由于创伤性风险较大,内镜治疗较为安全,可以作为CP治疗的一线首选治疗手段.
AIM： To compare the long-term clinical outcomes and complications between endoscopic and surgical treatment of chronic pancreatitis. METHODS： An electronic search of Medline, EMBASE, Science Direct, Springer link, CBM, CNKI, Wan fang and VIP databases （before December 21, 2013） was performed to retrieve the articles reporting endoscopic versus surgical treatment of chronic pancreatitis. The quality of the included trials was assessed according to the inclusive and exclusive criteria, and the data were extracted and analyzed using RevMan 5.2.7 software. RESULTS： A total of 5 articles involving 393chronic pancreatitis patients were included in the analysis, including 4 English articles and 1 Chinese article. The meta-analysis showed that the patients undergoing surgical treatment had higher rates of pain relief and complete pain relief （P 〈 0.05）, but there were no significant differences in the rate of partial relief, incidence of diabetes at 1, 3, and 5 years after treatment, the incidence of complications, or endocrine and exocrine functions of the pancreas （P 〉 0.05）. CONCLUSION： Surgical treatment is associated with better quality of life than endoscopic treatment. Due to the traumatic risk of surgery, endoscopic treatment is safe, and can be the first choice for treatment of chronic pancreatitis.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第15期2183-2189,共7页
World Chinese Journal of Digestology
