乳腺癌术后皮下积液相关危险因素的Meta分析

The Risk Factors of Seroma After Breast Cancer Surgery:A Meta-analysis

目的系统评价乳腺癌术后皮下积液的危险因素。方法计算机检索PubMed、Cochrane Library、Web of Science、Embase、万方、维普、中国知网、中国生物医学文献数据库,搜集乳腺癌术后皮下积液危险因素的病例—对照研究或队列研究,检索时间均为建库至2020年12月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,数据分析使用RevMan5.4软件。结果共纳入16个研究,包括3274例研究对象。Meta分析各危险因素的合并OR值及95%CI分别为:年龄1.09(1.04~1.14),BMI 1.41(1.16~1.71),合并糖尿病2.06(1.40~3.02),检出淋巴结数目1.53(1.22~1.91),腋窝淋巴结转移4.84(2.70~8.69),手术类型2.86(1.96~4.17),淋巴结清扫数目4.88(2.17~10.99),淋巴结清扫范围4.76(2.08~10.90),引流管数目2.47(1.59~3.83),拔管前引流量2.75(1.83~4.11),TTV154.87(3.55~6.69),术后放化疗2.65(1.65~4.28),应用生物蛋白胶0.23(0.13~0.40),皮瓣固定0.21(0.09~0.51)。结论年龄、BMI、合并糖尿病、检出淋巴结数目、腋窝淋巴结转移、淋巴清扫数目与范围、手术类型、引流管数目、拔管前引流量、TTV15、术后放化疗是乳腺癌术后皮下积液的危险因素,应用生物蛋白胶、皮瓣固定是乳腺癌术后皮下积液的保护因素。

Objective To systematically review the risk factors of postoperative seroma after breast cancer surgrey.Methods PubMed,Cochrane Library,Web of Science,Embase,Wanfang Data Databases,Vip,CNKI and CBM were electronically searched to collect case-control studies or cohort studies on the risk factors of seroma after breast cancer surgery from inception to December 2020.Two riviewers independently screened the literature,extracted data and assessed the quality of included studies,then meta-analysis was performed by using RevMan5.4 software.Results A total of 16 studies,involving 3274 cases were included.The OR and 95%CI of all risk factors in meta-analysis were respectively:age 1.09(1.04~1.14),BMI 1.41(1.16~1.71),concurrent diabetes 2.06(1.40~3.02),number of lymph nodes detected 1.53(1.22~1.91),axillary lymph node metastasis 4.84(2.70~8.69),type of surgery 2.86(1.96~4.17),number of lymph node dissection 4.88(2.17~10.99),range of lymph node dissection 4.76(2.08~10.90),number of drainage tube 2.47(1.59~3.83),drainage volume before extubation 2.75(1.83~4.11),TTV154.87(3.55~6.69),postoperative chemorotherapy 2.65(1.65~4.28),the protective factors included bioprotein glue 0.23(0.13~0.40),flap fixation 0.21(0.09~0.51).Conclusion Current evidence shows that the age,BMI,diabetesmellitus,check out the number of lymph nodes,number of axillary lymph node metastasis,lymphatic cleaning and scope,type of surgery,number of drainage tube,led traffic before extubation,TTV15,postoperative chemoradiotherapy are the risk factor of seroma after breast cancer surgrey,application of biological protein gel,flap fixed protection factor are the protective factors of seroma after breast cancer surgrey.