中心静脉导管持续引流治疗结核性胸腔积液的Meta分析

Efficacy of continuous central venous catheter drainage for tuberculous pleural effusion: a Meta-analysis

目的系统评价中心静脉导管持续引流治疗结核性胸腔积液的有效性。方法计算机检索Pub Med、Web of Science、The Cochrane Library、中国生物医学文献数据库、万方数据库和中国知网数据库,检索中心静脉导管持续引流与间断穿刺抽液治疗结核性胸腔积液的随机对照试验,检索时限从建库至2016年8月1日。由2位评价员按纳入与排除标准独立筛选文献、提取资料并评价质量后,采用Rev Man 5.3软件进行Meta分析。结果共纳入16个随机对照试验研究,1 243例患者。Meta分析结果显示:与间断胸腔穿刺抽液比较,中心静脉导管持续引流治疗结核性胸腔积液胸水消失时间短、退热时间短、胸水总引流量多、住院时间短、胸膜反应发生率低、医源性气胸发生率低、胸膜增厚发生率低,包裹性胸腔积液形成发生率低,均P<0.01,差异有统计学意义。结论中心静脉导管持续引流治疗结核性胸腔积液效果良好且并发症少。

Objective To evaluate the treatment effectiveness of continuous central venous catheter drainage of tuberculous pleural effusion. Methods We searched Pub Med, Web of Science, the Cochrane Library, Chinese Biomedical Literature Database, Wanfang Database and China National Knowledge Database and other databases to find relevant research literature on continuous central venous catheter drainage and intermittent puncture in treating tuberculous pleural effusion, and retrieved information up to August 1, 2016. Thereafter two reviewers, according to inclusion and exclusion criteria, independently screened the literature, extracted data and evaluated the quality of using RevMan 5.3 software for Meta-analysis. Results A total of 16 randomized controlled trials involving 1243 patients were included. The Meta-analysis showed that, compared with intermittent pleural puncture drainage, central venous catheters continuous drainage in the treatment of tuber-culous pleural effusion disappeared for a short while, the antipyretic time was shorter, the total drainage of pleural effusion became more, hospitalization was shorter, the incidence of pleural reaction lower, the incidence of iatrogenic pneumothorax lower, the incidence of pleural thickening lower, the incidence of pleural effusion formed lower, P〈 0.01, and the differences were statistically significant. Conclusion Continuous central venous catheter drainage of tuberculous pleural effusion can produce better results and fewer complications.