负压吸引对肺手术后临床疗效的Meta分析

Clinical effects of negative pressure suction after pulmonary surgery:a Meta-analysis

目的评价肺手术后胸腔闭式引流系统加用负压吸引的临床效果。方法计算机检索Cocharane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库,检索时间从各数据库建库至2015年1月;同时辅助其他检索,纳入肺手术后胸腔闭式引流系统加用负压吸引的随机对照试验(RCT)。由两名评价者独立评价纳入研究的质量并提取资料,并用Rev Man 5.0软件进行统计分析。结果共纳入10个随机对照试验,包括1211例患者。Meta分析结果显示,加用负压吸引能明显减少术后气胸的发生率[OR=0.23,95%CI(0.10,0.54),P<0.01];带管时间、漏气时间、迁延漏气时间、肺炎、心肺并发症、住院时间的差异均无统计学意义(P均>0.05)。结论肺切除术后胸腔闭式引流系统加用负压吸引并无明显优势,不提倡使用。

Objective To evaluate the clinical effects of negative pressure suction after pulmona-ry surgery. Methods Literature search was performed by using Cochrane Library,PubMed,EMBASE, CBM,CNKI,and VIP data from inception to January 2015 for randomized controlled trials（RCT）of closed thoracic drainage and negative pressure suction. The data and quality of those trails were independently e-valuated by two reviewers. Meta-analysis was conducted by using Revman5. 0 software. Results Ten pub-lished articles（1211 patients）were included. The results of meta-analysis showed that negative pressure suction reduced the incidence of postoperative pneumothorax significantly[OR = 0. 23,95% CI（0. 10, 0. 54）,P 〈 0. 01]. No differences were identified in duration of air leak,duration of chest tube,hospital stays,incidence of prolonged air leaks,pneumonia,and cardiopulmonary complications. Conclusion Closed thoracic drainage plus negative pressure suction has no obvious advantages,which is not recommen-ded after pulmonary surgery.