甲状旁腺全切除联合自体移植术在中国尿毒症SHPT病人中应用单组率Meta分析

Clinical application of total parathyroidectomy combined with autologous transplantationpatient for Chinese patients with secondary hyperparathyroidism:A single arm meta-analysis

目的通过分析甲状旁腺全切联合自体移植术在中国尿毒症继发甲状旁腺功能亢进(SHPT)病人中应用的全因病死率、术后并发症、术后复发率、1次手术成功率、术后症状缓解率,评价该术式的临床疗效。方法检索万方、维普、中国知网、PubMed等中英文数据库。纳入关于甲状旁腺全切联合自体移植术在中国尿毒症SHPT病人中应用的随机对照试验、非随机对照试验、病例对照研究、队列研究、病例报告论文纳入Meta分析。结果共纳入了12项研究,包含375例中国尿毒症病人。经过分析,甲状旁腺全切联合自体移植术在中国尿毒症SHPT病人中应用的术后并发症发生率P=0.15(95%CI 0.04～0.31);1次手术成功率P=0.93(95%CI 0.90～0.96);术后复发率P=0.11(95%CI 0.06～0.17);全因病死率P=0.04(95%CI 0.01～0.07);术后症状缓解率P=0.86(95%CI0.61～0.99)。结论甲状旁腺全切联合自体移植术在中国尿毒症SHPT病人中应用的疗效较为显著,术后不易复发且并发症的发生率较低。

Objective To study the curative effect of total parathyroidectomy combined with autologous transplantationpatient for Chinese patients with secondary hyperparathyroidism.Methods Chinese and English databases including Wanfang Science and Technology Periodical Full-text Database,VIP Chinese Science and Technology Periodical Full-text Database(VIP)and CNKI,PubMed were searched by computer.Some relevant studies were collected for Meta analysis.Results A total of 12 studies including a total of 375 subjects for Meta analysis were identified.After analysis,the postoperative complication rate was P=0.15(95% CI 0.04~0.31),the one-time success rate of surgical operation was P=0.93(95% CI 0.90~0.96),the rate of all-cause mortality was P=0.04(95% CI 0.01~0.07),and the rate of improvement of symptoms was P=0.86(95% CI 0.61~0.99).Conclusion The curative effect of total parathyroidectomy combined with autologous transplantation patient for Chinese patients with secondary hyperparathyroidism is effective.The incidence of postoperative complications is low.