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中华胃食管反流病电子杂志 ›› 2022, Vol. 09 ›› Issue (01) : 12 -18. doi: 10.3877/cma.j.issn.2095-8765.2022.01.003

论著

生物补片在腹腔镜下食管裂孔疝修补术中应用中的Meta分析
李赞林1, 李义亮1, 克力木·阿不都热依1,()   
  1. 1. 830001 乌鲁木齐,新疆维吾尔自治区人民医院微创疝与腹壁外科
  • 收稿日期:2021-02-18 出版日期:2022-02-15
  • 通信作者: 克力木·阿不都热依

Application of biological patch in laparoscopic repair of esophageal hiatal hernia: Meta analysis

Zanlin Li1, Yiliang Li1, Kelimu·Abudureyimu1,()   

  1. 1. Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
  • Received:2021-02-18 Published:2022-02-15
  • Corresponding author: Kelimu·Abudureyimu
引用本文:

李赞林, 李义亮, 克力木·阿不都热依. 生物补片在腹腔镜下食管裂孔疝修补术中应用中的Meta分析[J/OL]. 中华胃食管反流病电子杂志, 2022, 09(01): 12-18.

Zanlin Li, Yiliang Li, Kelimu·Abudureyimu. Application of biological patch in laparoscopic repair of esophageal hiatal hernia: Meta analysis[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2022, 09(01): 12-18.

目的

评价治疗生物补片治疗腹腔镜食管裂孔疝修补的临床疗效食管裂孔疝中的临床疗效。

方法

检索PubMed、EMbase、the Cochrane Library、万方、知网等数据库,检索时限为自建库至2020年,搜集生物补片在腹腔镜下食管裂孔疝修补术的临床对照试验,由2位研究员独立筛选文献及提取患者术前术后烧心、反流、胸痛及吞咽困难等指标的数据,采用Q检验和I2检验进行异质性评价。当异质性较大时(P<0.05或I2>50%)采用随机效应模型进行比较,反之采用固定效应模型。二分类变量采用相对危险度(RR)及其95%CI为效应量;连续性变量采用均数差(MD)及其95%CI表示。

结果

初步检索获得相关文献435篇文献,排除重复文献、与本研究无关文章及不符合本研究结局指标的文献,最终纳入研究8篇,共纳入患者237例。Meta分析结果显示,与术前相比腹腔镜下食管裂孔疝修补术后烧灼、反流、吞咽困难等症状评分比较差异均有统计学意义(P<0.05),提示腹腔镜下食管裂孔疝修补术后患者烧灼感、反流、吞咽困难等症状明显缓解;腹腔镜下食管裂孔疝修补术前后胸痛症状评分比较差异无统计学意义(P>0.05),但从森林图可以看出代表合并后效应量的菱形坐落于右侧,提示腹腔镜下食管裂孔疝修补术后患者胸痛症状较术前减轻,但减轻效果不明显。

结论

使用生物补片进行腹腔镜食管裂孔疝修补术是治疗食管裂孔疝的有效方法,是安全、有效的,明显降低术后并发症的发生。

Objective

To evaluate the clinical efficacy of biological patch in laparoscopic esophageal hiatal hernia repair in the treatment of esophageal hiatal hernia.

Methods

The databases of PubMed, EMbase, The Cochrane Library, Wanfang and Zhiwang were searched by computer, and the literatures were screened according to the inclusion criteria and exclusion criteria, and the relevant data were extracted, and the methodological quality evaluation and Meta analysis were carried out.

Results

A total of 8 articles and 237 patients were included. The results of Meta analysis showed that there were significant differences in the scores of sensation symptoms such as cauterization, reflux and dysphagia before and after laparoscopic esophageal hiatal hernia repair (P<0.05). It is suggested that the symptoms such as burning sensation, reflux and dysphagia after laparoscopic esophageal hiatal hernia repair are obviously relieved. There was no significant difference in the score of chest pain before and after laparoscopic esophageal hiatal hernia repair (P>0.05), but it can be seen from the forest map that the diamond representing the combined effect is located on the right side. it is suggested that the symptoms of chest pain after laparoscopic esophageal hiatal hernia repair are less than that before operation, but the relief effect is not obvious.

Conclusion

Laparoscopic esophageal hiatal herniorrhaphy with biological patch is an effective method for the treatment of esophageal hiatal hernia, which is safe and effective, and significantly reduces the incidence of postoperative complications.

图1 文献筛选流程
表2 纳入文献的基本特征
表3 纳入研究的偏倚风险评价
图2 纳入研究的偏倚风险评价图
图3 腹腔镜下食管裂孔疝修补术前后烧灼感症状评分比较的漏斗图
图4 腹腔镜下食管裂孔疝修补术前后烧心症状评分的比较
图5 腹腔镜下食管裂孔疝修补术前后反流症状评分的比较
图6 腹腔镜下食管裂孔疝修补术前后胸痛症状评分的比较
图7 腹腔镜下食管裂孔疝修补术前后吞咽困难症状的比较
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