胰十二指肠切除术后患者胃排空延迟危险因素的Meta分
析
李小祺;崔培元;鲁正;谈燚;吴维;吴华;吴斌全
【期刊名称】《中华肝胆外科杂志》 【年(卷),期】2016(022)005
【摘要】Objective To investigate the risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy,in order to provide a theoretical
basis
for
prevention The
term
and DGE
treatment was
of
this in
complication.Methods searched
Pubmed,Medline,EMBASE,Cochrane Library,CNKI,Wanfang,and
published literatures were collected to determine the risk factors of DGE after pancreaticoduodenectomy.The Review Manager 5.3 software was used in the analysis.Results A total of 52 articles were included.The results of Meta-analysis showed that age and preoperative bilirubin levels did not significantly influence the incidence of DGE.Preoperative cholangitis (OR =3.39,95％ CI 1.97 ～ 5.82),hypoalbuminemia (OR =2.53,95％ CI 1.59 ～4.02),and intraoperative blood loss of more than 1 L (OR =1.98,95％ CI 1.18 ～ 3.33) significantly increased the incidence of DGE.Pyloric resection (RR =2.06,95％ CI 1.05 ～4.05),antecolic reconstruction (RR =0.74,95％ CI 0.56 ～ 0.99) and Braun enteroenterostomy (OR =0.36,95％ CI 0.17 ～0.77) significantly decreased the risk of DGE.When compared with Roux-enY
enteroenterostomy,Billroth Ⅱ enteroenterostomy reduced the incidence of clinically relevant DGE (RR =0.30,95 ％ CI 0.11 ～ 0.79).Postoperative pancreatic fistula (OR =3.84,95 ％ CI 2.71 ～ 5.44) and intraabdominal infection/abscess (OR =3.95,95％ CI 2.87 ～ 5.43) were significantly associated
with
a
high
incidence blood
of
DGE.Conclusions postoperative
Hypoalbuminemia,cholangitis,large loss,and
abdominal complications were the risk factors of DGE.Pyloric resection,antecolic reconstruction,Billroth Ⅱ enteroenterostomy,and Braun enteroenterostomy significantly reduced the incidence of DGE.Subgroup analysis showed that differences on DGE definition in studies might be an important cause for the heterogeneity in the results of the different studies.%目的 研究胰十二指肠切除术后胃排空延迟(DGE)发生的危险因素,为临床防治提供理论依据.方法 通过检索Pubmed、Medline、EMBASE、Cochrane Library、中文期刊全文数据库和万方数据库等,查找公开发表在国内外期刊的胰十二指肠切除术后患者胃排空延迟危险因素的文献,符合纳入标准的文献资料,运用Review Manager 5.3进行合并分析.结果 共纳入52篇文献,Meta分析结果如下:年龄、术前总胆红素水平对DGE发生率无明显影响;术前合并胆管炎(OR =3.39,95％ CI:1.97 ～5.82)、低蛋白血症(OR =2.53,95％ CI:1.59 ～4.02)、术中出血量大于1L(OR=1.98,95％ CI:1.18～3.33)、术后胰漏(OR =3.84,95％ CI:2.71 ～5.44)和腹腔感染/脓肿组(OR =3.95,95％ CI:2.87 ～5.43)可导致DGE发生率明显增高;切除幽门可降低DGE发生率(RR =2.06,95％CI:1.05～4.05);结肠前吻合比结肠后吻合DGE发生率低
(RR =0.74,95％ CI:0.56 ～0.99);毕Ⅱ式吻合比Roux-en-Y吻合临床相关DGE发生率低(RR =0.30,95％ CI:0.11 ～0.79);布朗吻合可降低临床相关DGE的发生率(OR=0.36,95％CI:0.17 ～0.77).结论 术前低蛋白血症、胆管炎、术中失血量大和术后腹腔并发症是DGE发生的高危因素,而幽门切除、结肠前吻合、毕Ⅱ式吻合和布朗吻合可降低DGE发生率.亚组分析发现DGE定义不同是本研究异质性来源之一.
【总页数】5页(320-324)
【关键词】胰十二指肠切除术;胃排空延迟;Meta分析 【作者】李小祺;崔培元;鲁正;谈燚;吴维;吴华;吴斌全
【作者单位】233000 安徽,蚌埠医学院第一附属医院肝胆外科;233000 安徽,蚌埠医学院第一附属医院肝胆外科;233000 安徽,蚌埠医学院第一附属医院肝胆外科;233000 安徽,蚌埠医学院第一附属医院肝胆外科;233000 安徽,蚌埠医学院第一附属医院肝胆外科;233000 安徽,蚌埠医学院第一附属医院肝胆外科;233000 安徽,蚌埠医学院第一附属医院肝胆外科 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-hepatobiliary-surgery_thesis/0201234584309.html 【相关文献】
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2.胰十二指肠切除术后患者胃排空延迟高危因素研究 [J], 党铁成; 王金柱; 李小杰
3.保留幽门的胰十二指肠切除与标准胰十二指肠切除术后胃排空延迟的对比研究 [J], 许胜; 俞文隆; 张永杰
4.老年患者胰十二指肠切除术后胃排空延迟的危险因素 [J], 张哲栋; 张大方; 谢文勇; 刘以俊; 郑晟旻; 朱卫华; 李澍; 朱继业
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胰十二指肠切除术后患者胃排空延迟危险因素的Meta分析
