妇科恶性肿瘤术后行盆腔引流管置入效果的Meta分析

摘要

Objective To systematically evaluate the outcomes of retroperitoneal drainage versus no drainage after pelvic lymphadenectomy in gynaecological cancer patients.Methods Databases such as Medline, EMBASE, Science Direct,Springer link,CBM,CNKI,PUBMED、Wan fang and VIP databases were searched comprehensively. We retrieval the articles which reporting outcomes compared no drainage with drainage following lymphadeneetomy,the latest searches were performed on 31 December 2014.Based on the including and excluding criteria,literatures that were eligible were screened and data were retrieved.RevMan 5.2.7 software was applied to perform the Meta-analy-sis.Results A total of 10 articles were eligible for the Meta-analysis,involving 1238 patients ,including 6 English articles and 4 Chinese article.The meta-analysis showed that the patients postoperative with drainage tube bearing lon-ger of bowel sounds recovery (P<0.01),but there were no statistically significant differences in the febrile morbidity and lymphcyst formation.After the eradicative resection of gynecological malignant tumor,drainage tube, s placement donnot reduce febrile morbidity,lymphcyst formation,but prolong the recovery time of gastrointestinal tract.Conclu-sion When the pelvic peritoneum was left open,and surgery without a lot of bleeding or exudation ,drainage is not needed.%目的比较妇科恶性肿瘤术后有无放置盆腔引流管的临床转归。方法全面检索2014年12月31日前在Medline、EMBASE、Science Direct、Springer link、CBM、中国知网、PUBMED、万方以及维普数据库公开发表关于妇科恶性肿瘤术后无引流管与置引流管患者比较的文献，按纳入排除标准由2位研究者独立进行文献筛选、资料提取和方法学质量评价后，采用RevMan 5．2．7软件进行Meta分析。结果共纳入10篇研究，其中包含6篇英文文献，4篇中文文献，共包含妇科恶性肿瘤术后患者1238例，Meta分析结果显示：术后无引流管组肠鸣音恢复时间较置引流管管组明显缩短（P＜0．01），术后无引流管组和置引流管组的术后发热率、淋巴囊肿形成率均差异无统计学意义。妇科恶性肿瘤淋巴结清扫术后，盆腔引流管的放置不能减少发热发病率、淋巴囊肿形成率，反而延长胃肠功能恢复时间。结论手术后腹膜没有关闭的前提下，手术没有大量出血或渗液时，可以不需要引流。