摘要
目的:评价腹腔镜辅助的阴式根治性子宫切除术(laparoscopic assisted radical vaginal hysterectomy,LARVH)的临床效果。方法:采用RevMVan4.2.2软件,对符合入选标准的8篇文献进行了固定或随机效应模型Meta分析。结果:与常规经腹根治性子宫切除术(radical abdominal hysterectomy)组相比,腹腔镜辅助的阴式根治性子宫切除术(laparoscopic assisted rad-ical vaginal hysterectomy,LARVH)组手术时间长〔WMD=36.67,95%CI(16.36,56.98)〕,具有术中出血量少、住院时间短、术后并发症少等优点〔合并统计量分别为WMD=-255.12,95%CI(-419.90,-90.35);WMD=-3.79,95%CI(-5.19,-2.39);OR=0.21,95%CI(0.05,0.87)〕,而在复发率和术中并发症发生率上则无统计学差异(P=0.73,P=0.68)。结论:Meta分析表明,与常规经腹根治性子宫切除术相比,腹腔镜辅助的阴式根治性子宫切除术安全可行,能缩短住院时间,减少术中出血量,降低术后各种近期并发症的发生率,虽然延长手术时间,但不会增加手术复发率和术中并发症的发生率,可作为临床优先选择的术式。但由于纳入的研究存在选择偏倚和测量偏倚的可能性,势必会影响结果的论证强度,需要更多高质量的随机双盲对照试验来进一步证实。
Objective：To evaluate the therapeutic effect of laparoscope-assisted radical vaginal hysterectomy （LARVH）.Methods：RevMVan4.2.2 software was used for fixed or random effects model Meta analysis of eight articles meeting the inclusion criteria.Results：Compared with conventional radical abdominal hysterectomy group,the operation time of LARVH group was longer〔WMD=36.67,95% CI （16.36,56.98） 〕,LARVH had the advantages of less intraoperative bleeding volume,shorter hospitalization time and fewer postoperative complications〔WMD=-255.12,95% CI （-419.90,-90.35） ;WMD=-3.79,95% CI （-5.19,-2.39） ;OR=0.21,95% CI （0.05,0.87） 〕;there was no significant difference in relapse rate and incidence of intraoperative complications between the two groups （P=0.73,P=0.68）.Conclusion：Compared with conventional radical abdominal hysterectomy,LARVH is safe and feasible,which can shorten hospitalization time,reduce intraoperative bleeding volume and the incidences of all kinds of postoperative short term complications;although LARVH lengthens operation time,it doesn＇t increase the relapse rate and incidence of intraoperative complications,which can be used as the first choice;owing to the probability of selection bias and measurement bias in inclusion study,the argument strength of the outcome will be affected,more high-quality randomized double-blind controlled trials are needed for further research.
出处
《中国妇幼保健》
CAS
北大核心
2010年第29期4315-4317,共3页
Maternal and Child Health Care of China
基金
广西医疗卫生重点科研课题(No.重200704)
