脾切除术与部分脾动脉栓塞术治疗肝硬化脾功能亢进近期疗效比较的Meta分析

何海冠; 沈艺南; 庞书杰; 杨田; 卢军华

doi:10.3969/j.issn.1001-5256.2016.02.021

脾切除术与部分脾动脉栓塞术治疗肝硬化脾功能亢进近期疗效比较的Meta分析

DOI: 10.3969/j.issn.1001-5256.2016.02.021

东方肝胆外科医院肝外五科

基金项目:

国家自然科学基金资助项目(81172020;81372262)；

详细信息

中图分类号: R657.63
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出版历程
- 收稿日期: 2015-07-27
- 出版日期: 2016-02-20

Short-term efficacy of splenectomy versus partial splenic embolization for liver cirrhosis and hypersplenism: a Meta-analysis

The 5th Department of Hepatic Surgery,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University

Research funding:

摘要

摘要: 目的系统评价部分脾动脉栓塞术（PSE）和脾切除术治疗肝硬化脾功能亢进的疗效。方法计算机检索2005年1月1日-2015年5月30日Medline、Embase、Web of Science、中国知网、万方数据库、维普收录的评估PSE与脾切除术治疗肝硬化脾功能亢进疗效的文献,文献纳入由两位研究者独立筛选,经过质量评价与数据提取后,采用Rev Man5.3进行Meta分析。结果最终纳入10篇对照研究,共638例患者。4项研究的合并分析结果显示术后1周PSE组对外周血小板的影响明显低于脾切除术组[加权均数差（WMD）=-65.71,95%可信区间（95%CI）:-120.24-11.18,P=0.02];而术后1个月两组差异无统计学意义（WMD=0.68,95%CI:-8.169.52,P=0.88）;2项研究的合并分析结果显示术后1个月PSE组自然杀伤细胞的含量较脾切除术组高（WMD=6.03,95%CI:3.808.26,P<0.001）,且术后1年两组差异仍有统计学意义（WMD=3.60,95%CI:1.25
- 肝硬化 /
- 脾功能亢进 /
- 栓塞,治疗性 /
- 脾切除术 /
- Meta分析
Abstract: Objective To systematically evaluate the therapeutic effects of partial splenic embolization( PSE) and splenectomy for liver cirrhosis and hypersplenism. Methods The Medline,Embase,Web of Science,CNKI,Wanfang Data,and VIP were searched to collect the articles on PSE and splenectomy for liver cirrhosis and hypersplenism published between January 1,2005 and May 30,2015. The inclusion of articles was performed by two investigators independently,and after quality assessment and data extraction,Rev Man 5. 3 was applied for the Meta- analysis. Results A total of 10 control studies involving 638 patients were included. The results of the pooled analysis of 4 studies showed that the peripheral platelet counthad a significant difference between the PSE group and the splenectomy group at 1 week after surgery( WMD =- 65. 71,95% CI:- 120. 24 to- 11. 18,P = 0. 02),but showed no significant difference at 1 month after surgery( WMD =0. 68,95% CI:- 8. 16- 9. 52,P = 0. 88). The results of the pooled analysis of 2 studies showed that at 1 month after surgery,the PSE group had a significantly higher number of natural killer cells than the splenectomy group( WMD = 6. 03,95% CI: 3. 80- 8. 26,P < 0. 001),but there was no difference in this number at 1 year after surgery between the two groups( WMD = 3. 60,95% CI: 1. 25- 5. 96,P = 0. 003).The results of the pooled analysis of 3 studies showed that the PSE group had a significantly shorter hospital stay than the splenectomy group( WMD =-2. 52,95% CI:-3. 36 to-1. 67,P <0. 001). Conclusion Compared with the splenectomy group,the short- term increase in platelet count after surgery is alleviated in the PSE group,while there is no significant difference in long- term platelet count; PSE has significant advantages in maintaining the reserve function of immune system,shortening the length of hospital stay,and reducing complications in postoperative patients.
- liver cirrhosis /
- hypersplenism /
- embolization,therapeutic /
- splenectomy /
- Meta-analysis

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参考文献(17)

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