机械性肠道准备在择期结直肠手术中应用的Meta分析

Application of mechanical bowel preparation in elective colorectal surgery:a meta-analysis

[目的]系统评价机械性肠道准备(MBP)在择期结直肠手术中应用的临床价值。[方法]采用Cochrane系统评价方法,检索2005年—2015年Cochrane Library、PubMed、Embase、Web of Science、CBM数据库,由2名评价员独立提取信息并评价文献质量,评价指标包括吻合口漏、伤口感染和腹腔脓肿发生率,采用RevMan5.3软件进行Meta分析。[结果]共有10篇论文进入Meta分析,试验组在择期结直肠手术前进行MBP,对照组手术前不进行MBP;Meta分析结果显示:两组吻合口漏发生率[OR=0.85,95%CI(0.62~1.17),P=0.32]、伤口感染发生率[OR=1.15,95%CI(0.93~1.42),P=0.18],差异均无统计学意义(P>0.05);两组腹腔脓肿发生率[OR=0.61,95%CI(0.40~0.94),P=0.02],差异具有统计学意义(P=0.02)。[结论]没有充足的证据支持在择期结直肠手术中使用MBP,可降低吻合口漏、伤口感染,还需进一步研究。

Objective： To systematic review the clinical value of mechanical bowel preparation （MBP） in electivecolorectal surgery. Methods： Cochrane systematic review was used to retrieve the data from Cochrane L ib ra ry ,PubMed ,Embase, Web of Science and CBM from 2005 to 2015. The quality of li terature was independently eval-uated by two evaluators, the indicators for assessment including the rate of anastomotic leak^wound infectionand abdominal abscess incidence. The results were analyzed with RevMan 5. 3 software. Results： A total of 10 pa-pers were included in the meta - analysis. In experimental group,MBP was performed before elective colorectalsurgery. In control group？MBP was not performed before an operation. Meta - analysis showed that there wereno statistically significant differences between two groups in the incidence of anastom95% CI（0. 62 1. 17）,P = 0. 32] and the incidence of wound infection[OR= 1. 15,95%C10. 93 1.42） ,P = 0. 18] （P 〉0. 05）. There was statistically significant difference in incidence of abdominal abscess between the two groups[0R = 0. 61,95 % 1（0. 40-0. 94）, P = 0. 02]. Conclusions ： There were insufficient evidences to support that the use of MBP during elective colorectal surgery may reduce anastomotic leakage and wound infection.Further study is needed.