胃肠减压在胃癌根治术后有效性的Meta分析

摘要

Objective To assess the effectiveness of nasogastric decompression after radical operations for gastric cancer. Methods We searched PubMed, EMBase, the Cochrane Library, Chinese Biomedical Literature Database, Chinese Scientific Journals full - text database and Chinese Journal full - text database and bibliographies of retrieved articles for randomized controlled trials up to the requirement and analyzed the data using Review Manager 5. 0. Results SLx randomized controlled trials were included. The results of meta analysis showed that there was significant difference between nasogastric decompression group and non - nasogastric decompression group with regards to the first ventilation time [ MD = - 0. 50 , 95% CI ( - 0. 94, -0. 06 ) ], while sensitivity analysis indicated that the difference concerning the first ventilation time between the two groups was not significant [ MD =-0. 28, 95%CI( -0.63, 0.08)]. Besides, no significance was found in the rate of incidence of pulmonary complications [ RR =0.77, 95% CI ( 0.43, 1.39 )], incidence of wound infection [ RR =0.39, 95% CI ( 0. 12, 1.20)], incidence of anastomotic leak [ RR = 0. 77 , 95 % CI ( 0. 33 , 1. 81 ) ] and hospital stay [ MD = - 2. 70 , 95 % CI ( -3. 92, - 1. 47 ) ]. Conclusion Current evidences does not support the benefit of nasogastric decompression after radical operations for gastric cancer.%目的 评价胃肠减压在胃癌根治术后的有效性.方法计算机检索PubMed、EMBase、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、维普中文科技期刊数据库,手工检索相关领域的期刊,同时从纳入文献的参考文献中查找符合要求的随机对照试验,采用RevMan 5.0软件进行统计分析.结果 共纳入6篇随机对照试验,Meta分析结果显示:胃癌根治术后胃肠减压组与非胃肠减压组第一次通气时间比较,差异有统计学意义[MD=-0.50,95%CI(-0.94,-0.06)];敏感性分析结果显示:两组第一次通气时间比较,差异无统计学意义[MD=-0.28,95%CI(-0.63,0.08)];两组肺部并发症发生率[RR=0.77,95%CI(0.43,1.39)]、切口感染发生率[RR=0.39,95%CI(0.12,1.20)]、吻合口漏发生率[RR=0.77,95%CI(0.33,1.81)]、住院时间[MD=-2.70,95%CI(-3.92,-1.47)]比较,差异均无统计学意义.结论 当前证据表明胃癌根治术常规放置胃肠减压管并不能使患者受益.