摘要
目的 分析各种术式治疗肝内胆管结石的疗效。 方法 采用荟萃分析的方法对同济医院普外科 2 84例及国内 1 990年 1月至 2 0 0 1年 3月报道的 2 671例采用不同术式治疗的肝内胆管结石患者的随访资料进行综合定量分析。 结果 非肝切除术对肝内胆管结石的疗效与肝切除术相比 ,二者之间的差异具有非常显著的意义 (χ2 =62 941 ,P <0 0 1 ) ,且肝切除术与疗效优良的相关性明显高于非肝切除术 (ORS=0 30 3 ,95 %可信区间在 0 2 2 2～ 0 41 3)。间置空肠术的疗效与肝切除术的疗效相比关系不定 (RR =1 0 1 ,95 %可信区间为 0 98～ 1 0 4 )。其他术式与肝切除术相比 ,疗效均较差(RR值的 95 %上限小于 1 )。 结论 肝切除术是目前治疗肝内胆管结石的最为理想的术式 ;手术应当多样化 。
Objective To compare curative effects of various surgical procedures of bile duct stones. Methods Two thousand nine hundred and fifty five patients with intrahepatic bile duct lithiasis who had undergone various surgical procedures were analysed with Meta analysis. Some of these cases were reported in Chinese Medical Journals from January 1990 to March 2001 and others were from Tongji Hospital. Results There was a significant difference between curative effects of nonhepatocetomy and that of hepatoectomy(χ 2=62 945, P <0 01), and the outcomes of hepatoectomy were much better than those of nonhepatoectomy with OR S equalled to 0 303(0 222～0 413). There was not a significant difference between curative effect of interposed jejunum and that of hepatoectomy(95%CI of RR from 0 98 to 1 04). All the other operation, effects were worse than hepatoectomy(upper limit of 95%CI of RR<1). Conclusions Hepatoectomy is the most ideal surgery for intrahepatic bile duct stones and operation methods should be diversified since good effect could also be obtained when other operations are performed on suitable cases.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2003年第7期509-512,共4页
Chinese Journal of Surgery
关键词
肝内胆管结石
外科治疗
肝切除术
手术方式
Bile ducts,intrahepatic
Cholelithiasis
Surgical procedures,operative
Evidence based medicine
