超声刀在甲状腺切除术中应用效果的Meta分析
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赛力克·马高维亚, Email: sairike@126.com

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Efficacy of ultrasonic scalpel application in thyroid surgery: a Meta-analysis
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    摘要:

    目的:综合评价超声刀在开放性甲状腺切除术中的应用价值。 方法:检索国内数据库上所有关于超声刀在开放性甲状腺切除术中使用的随机对照试验(RCT)。按照纳入排除标准筛选和提取数据,并采用RevMan5.2软件进行统计学分析。 结果:最终纳入13个随机对照试验,共1 527例患者。Meta分析结果显示,与传统手术方法比较,超声刀能缩短甲状腺全切除术和甲状腺腺叶切除术的手术时间(WMD=-22.73,95%CI=-29.15--16.32,P<0.00001;WMD=-16.21,95%CI=-19.74--12.69,P<0.00001);可以减少甲状腺全切术时术中出血量和术后引流量(WMD=-31.00,95%CI=-38.85--23.15,P<0.00001;WMD= -12.56,95%CI=-21.36--3.76,P=0.005),以及术后暂时性低钙血症发生率(OR=0.59,95%CI=0.42-0.83,P=0.003)。喉返神经麻痹发生率方面,超声刀和传统手术无统计学差异(OR=1.38,95%CI=0.70-2.74,P=0.35)。 结论:超声刀能缩短甲状腺切除术中的手术时间、术中出血量、术后引流量以及术后低钙血症的发生率。

    Abstract:

    Objective: To systematically evaluate the application value of ultrasonic scalpel in open thyroid surgery. Methods: The literature of randomized controlled trials (RCTs) concerning the use of ultrasonic scalpel in open thyroid surgery was retrieved by searching national and international databases. Data were screened and extracted according to the inclusion and exclusion criteria, and were statistically analyzed by using RevMan 5.2 analysis software. Results: Thirty RTCs were finally included, with a total of 1 527 patients. Meta-analysis results showed that compared with conventional surgery, usage of the ultrasonic scalpel reduced the operative time for either total thyroidectomy or thyroid lobectomy (WMD=–22.73, 95% CI=–29.15––16.32, P<0.00001; WMD=–16.21, 95% CI=–19.74––12.69, P<0.00001), decreased the intraoperative blood loss and postoperative drainage volume as well as the postoperative incidence of transient hypocalcemia in total thyroidectomy (WMD=–31.00, 95% CI=–38.85––23.15, P<0.00001; WMD=–12.56, 95% CI=–21.36––3.76, P=0.005; OR=0.59, 95% CI=0.42–0.83, P=0.003). No significant difference was noted in incidence of recurrent laryngeal nerve palsy between surgery with ultrasonic scalpel and conventional procedure (OR=1.38, 95% CI=0.70–2.74, P=0.35). Conclusion: The use of ultrasonic scalpel in open thyroid surgery can reduce the operative time, intraoperative blood loss, postoperative drainage volume and incidence of transient hypocalcemia.

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巴合提·卡力甫|艾则孜·阿不都热依木|赛力克·马高维亚|哈尔满·阿吉汗|热依汗古丽|田野|王护国|吾甫尔·依马尔|哈力木拉提·木尔提扎.超声刀在甲状腺切除术中应用效果的Meta分析[J].中国普通外科杂志,2013,22(5):601-607.
DOI:10.7659/j. issn.1005-6947.2013.05.015

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  • 收稿日期:2013-01-04
  • 最后修改日期:2013-04-28
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  • 在线发布日期: 2013-05-15