国内拖线术治疗肛瘘的临床疗效性及安全性的系统评价

摘要

目的：系统评价国内拖线或拖线联合辅助疗法治疗肛瘘的临床疗效性及安全性。方法：计算机检索 CNKI（2005—2012）；VIP、社科期刊数据库（2005—2012）；WanFang Data、博硕士论文、会议论文数据库（2005—2012）和中国生物医学文献服务系统（2005—2012）数据库，查找拖线术为主治疗肛瘘的随机对照试验（RCT），同时追溯相关文献的参考文献。按照纳入和排除标准筛选文献、提取资料和评价质量后，采用 RevMan4.2软件进行 Meta －分析。结果：共纳入12个 RCT， Meta －分析结果显示：拖线术能有效提高肛瘘的治疗效果，减少肛门失禁，保护肛门功能，与传统肛瘘切开和／或切开挂线术相比，其差异均有统计学意义（P ＜0.01）。结论：现有循证医学证据显示拖线术能有效地保护肛门功能，提高肛瘘的一次性治愈率。但受纳入研究数量和质量限制，上述结论尚需开展更多大样本的随机对照试验加以验证。%Objective:To evaluate the efficacy and safety of thread-dragging through fistula method (TDFM)in treating patients with anal fistula.Methods:Databases such as CNKI (2005 to 2012),VIP (2005 to 2012)and Wanfang Data (2005 to 2012) etc.were electronically searched for randomized controlled trials (RCTs)on different surgical (basing on TDFM)treatments for a-nal fistula,and the relevant references were also retrieved.According to the inclusion and exclusion criteria,we screened literature, extracted data,and critically assessed the quality of RCTs.Then the meta-analysis was conducted using RevMan 4.2 software.Re-sults:A total of 12 RCTs were included.The results of meta-analyses showed that TDFM could improve efficacy,reduce fecal in-continence,protect anal function (P <0.01).Conclusion:Current evidence shows TDFMcan effectively improve efficacy,protect anal function.But this conclusion still needs to be proven by large-scale RCTs due to the limited quantity and quality of the includ-ed studies.