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半肝阻断法和全肝阻断法在原发性肝癌肝切除术中应用效果比较的Meta分析

刘莹 高本见 杨小李 方程 苏松 李波

刘莹, 高本见, 杨小李, 等. 半肝阻断法和全肝阻断法在原发性肝癌肝切除术中应用效果比较的Meta分析[J]. 临床肝胆病杂志, 2021, 37(1): 73-78. DOI: 10.3969/j.issn.1001-5256.2021.01.015
引用本文: 刘莹, 高本见, 杨小李, 等. 半肝阻断法和全肝阻断法在原发性肝癌肝切除术中应用效果比较的Meta分析[J]. 临床肝胆病杂志, 2021, 37(1): 73-78. DOI: 10.3969/j.issn.1001-5256.2021.01.015
LIU Y, GAO BJ, YANG XL, et al. Effect of hemihepatic vascular exclusion versus total hepatic vascular exclusion in hepatectomy for primary liver cancer: A Meta-analysis[J]. J Clin Hepatol, 2021, 37(1): 73-78. DOI: 10.3969/j.issn.1001-5256.2021.01.015
Citation: LIU Y, GAO BJ, YANG XL, et al. Effect of hemihepatic vascular exclusion versus total hepatic vascular exclusion in hepatectomy for primary liver cancer: A Meta-analysis[J]. J Clin Hepatol, 2021, 37(1): 73-78. DOI: 10.3969/j.issn.1001-5256.2021.01.015

半肝阻断法和全肝阻断法在原发性肝癌肝切除术中应用效果比较的Meta分析

DOI: 10.3969/j.issn.1001-5256.2021.01.015
基金项目: 

国家自然科学基金资助项目 81802778

详细信息
    作者简介:

    刘莹(1995—),女,主要从事肝胆外科临床研究

    通讯作者:

    李波,liboer2002@126.com

  • 利益冲突声明:本研究不存在研究者以及与公开研究成果有关的利益冲突,特此声明。
  • 作者贡献声明:刘莹、高本见负责课题设计,收集数据,资料分析,撰写论文;杨小李、方程、苏松参与修改论文;李波负责指导撰写文章并最后定稿。
  • 中图分类号: R735.7

Effect of hemihepatic vascular exclusion versus total hepatic vascular exclusion in hepatectomy for primary liver cancer: A Meta-analysis

  • 摘要:   目的  比较普林格尔法(Pringle’s measure, PM)和半肝血管流入阻断法(HVO)在原发性肝癌肝切除术中的应用效果。  方法  计算机检索中、英文数据库中关于HVO和PM治疗原发性肝癌的对照研究,查找时间为数据库建立至2020年6月。对纳入的研究进行质量评价和数据提取后,采用RevMan5.3软件进行Meta分析。  结果  共纳入10项研究,合计1272例患者。HVO组术后第1、3天ALT水平低于PM组[均数差(MD)=-172.71,95%CI:-289.26~-56.16,P=0.004;MD=-130.35,95%CI:-221.25~-39.45,P=0.005],术后第3天AST水平低于PM组(MD=-84.56,95%CI:-166.47~-2.65,P=0.04),术后第1、3天Alb水平高于PM组(MD=1.31,95%CI:0.06~2.56,P=0.04;MD=1.81,95%CI:0.27~3.35,P=0.02),手术时间较PM组长(MD=8.95,95%CI:4.30~13.60;P<0.01)。  结论   HVO是一种安全有效的血流阻断方法,与PM相比能有效减轻肝损伤。但外科医生还应根据个人经验、患者病情以及术中具体情况选择适合患者的阻断方法。
  • 图  1  文献筛选流程图

    图  2  2组术后第1、3、5天ALT水平的Meta分析

    图  3  2组术后第1、3、5天AST水平的Meta分析

    图  4  2组术后第1、3、5天Alb水平的Meta分析

    图  5  2组术后第1、3、5天TBil水平的Meta分析

    图  6  2组手术时间的Meta分析

    图  7  2组术中出血量的Meta分析

    图  8  2组术中输血率的Meta分析

    图  9  2组术后总体并发症的Meta分析

    图  10  2组住院时间的Meta分析

    表  1  纳入文献基本特征及质量评价

    作者 年份 国家 研究类型 手术分组 样本量(例) 年龄(岁) 男/女(例) 肿瘤大小(cm) 质量评分(NOS/Jadad量表)
    Huang等[13] 2014 中国 RCS HVO 126 49.3±12.8 97/29 - 8
    PM 158 48.5±12.0 129/29 -
    Li等[14] 2017 中国 RCS HVO 26 53(34~72)1) 20/6 - 8
    PM 37 47.5(25~70)1) 33/4 -
    Ni等[15] 2013 中国 RCT HVO 60 56.1±9.3 47/13 4.7±2.2 3
    PM 60 55.2±8.7 45/15 5.4±3.1
    Fu等[16] 2011 中国 RCT HVO 60 49.3±9.2 41/19 6±2.8 3
    PM 60 48.6±8.7 46/14 6.8±2.8
    蔡鸿宇等[17] 2019 中国 RCT HVO 76 54.11±7.75 59/17 5.03±2.86 3
    PM 76 53.24±7.83 56/20 5.77±3.74
    曾三平[18] 2020 中国 RCT HVO 40 48.6±3.1 22/18 - 3
    PM 40 48.8±3.0 23/17 -
    韩玉龙等[19] 2018 中国 RCS HVO 44 - - 10.1±3.1 7
    PM 52 - - 9.6±3.0
    乔海军等[20] 2018 中国 RCS HVO 54 57.35±9.06 35/19 6.47±1.42 8
    PM 70 56.94±8.72 46/24 6.51±1.38
    吴宗杨等[21] 2014 中国 RCT HVO 35 - - - 3
    PM 35 - - -
    庄盛威等[22] 2018 中国 RCS HVO 31 49.62±4.91 24/7 9.07±0.99 8
    PM 42 49.09±4.51 32/10 9.31±0.75
    注:1)M(P最小值~P最大值);“-”表示未提及。
    下载: 导出CSV
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  • 收稿日期:  2020-08-06
  • 修回日期:  2020-08-21
  • 刊出日期:  2021-01-18
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