肺癌术后不同时机拔除胸腔引流管临床结局比较的网状Meta分析

Comparative effectiveness of different movement therapies for improving upper motor function in children with hemiplegic cerebral palsy:A network Meta⁃analysis

目的采用网状Meta分析方法系统评价肺癌术后24 h引流量<100 ml、200 ml、300 ml、400 ml不同时机拔管的临床结局。方法在PubMed、EMBASE、The Cochrane Library、Web of Science以及中文数据库万方、CBM、CNKI检索关于肺癌术后不同时机拔管的随机对照试验(randomized controlled trial,RCT),检索时限从建库到2019年11月。按照纳入标准进行文献筛选、数据提取及质量评价后,采用stata 14.0和Review Manage软件进行网状Meta分析。结果通过直接Meta分析发现胸腔积液100 ml与300 ml(RR:0.41,95%CI:0.19~0.90,P=0.03);二次置管100 ml与300 ml比较(RR:0.43,95%CI:0.19~0.97,P=0.04);100 ml与200 ml比较(MD:1.70,95%CI:0.57~2.82,P=0.003);100 ml与300 ml比较(MD:2.32,95%CI:1.31~3.33,P<0.001);200 ml与300 ml比较(MD:1.68,95%CI:1.34~2.01,P<0.001)。结论胸腔引流液拔除管道住院时间短,相比并发症高。胸腔引流液100 ml时拔除胸腔闭式引流管,并发症发生率低,胸腔引流液150 ml时拔除为最佳时间。

Objective To systematically evaluate and analyze the clinical outcomes of extubation at different times when the drainage volume of lung cancer is less than 100 ml,200 ml,300 ml,400 ml 24 hours after operation by using reticular Meta⁃analysis.Methods randomized controlled trial(RCT)of extubation at different times after lung cancer surgery was searched in PubMed,EMBASE,The Cochrane Library,Web of Science and Chinese databases Wanfang,CBM and CNKI.The search time was from the establishment of the database to November 2019.Two researchers conducted literature screening,data extraction and quality evaluation according to the inclusion criteria,and then used stata 14.0 and Review Manage software to conduct network Meta⁃analysis.Results Through direct meta⁃analysis,the pleural effusion was 100 ml and 300 ml(RR:0.41,95%CI:0.19~0.90,P=0.03).100 ml of secondary catheter was compared with 300 ml(RR:0.43,95%CI:0.19~0.97,P=0.04);100 ml compared with 200 ml(MD:1.70,95%CI:0.57~2.82,P=0.003);100 ml compared with 300 ml(MD:2.32,95%CI:1.31~3.33,P<0.001);200 ml compared with 300 ml(MD:1.68,95%CI:1.34~2.01,P<0.001).Conclusion The more pleural drainage fluid,the shortest hospitalization time after removing the tube,but the highest complications.When the thoracic drainage fluid is 100ml,the closed thoracic drainage tube is removed,and the complication rate is the lowest,but the hospitalization time is long.Therefore,according to the analysis of the final data in this paper,it is the best scheme to remove the pleural fluid when it is 150 ml.