目的对透明质酸预防术后盆腹腔粘连的疗效及安全性进行系统评价。方法制定详细的检索策略及纳入和排除标准。计算机检索Cochrane图书馆，Embase数据库，PubMed数据库，SCI数据库，中国生物医学数据库(CBM)，中国学术期刊网络出版总库(CNKI)，中文科技期刊全文数据库(VIP)和万方-数字化期刊全文库(Wanfang)。根据标准纳入透明质酸预防盆腹腔术后粘连的随机对照试验，并对纳入的研究进行质量评价和Meta分析。结果最终纳入5个高质量随机对照试验。试验组和对照组的术后粘连发生率的差异具有统计学意义(P＜0.00001);膜剂、溶液剂的试验组和对照组粘连范围级数差异均具有统计学意义(均为P＜0.00001);膜剂、溶液剂的试验组和对照组粘连程度的差异均具有统计学意义(均为P＜0.00001)。安全性方面，两组总不良反应发生率的差异没有统计学意义(P=0.07)。结论盆腹腔手术后应用透明质酸可降低粘连发生率，缩小粘连范围和减轻粘连程度，不良反应发生率的风险小。谨慎把握适应证，操作规范，应用透明质酸可有效预防术后盆腹腔粘连。
Abstract
OBJECTIVE To explore the effectiveness and safety of hyaluronic acid in preventing postoperative abdominopelvic adhesions. METHODS Appropriate search strategy and inclusion and exclusion criteria were made. The Cochrane Library,EMBASE,PubMed,ISI database,CBM,CNKI,VIP,and Wanfang database were searched for randomized controlled trials (RCTs) about hyaluronic acid in preventing postoperative abdominopelvic adhesions. RCTs were selected and included according to the inclusion and exclusion criteria. Then quality assessment and meta-analysis were conducted on the included RCTs. RESULTS Five high quality RCTs were included. Statistical difference was detected in the rate of postoperative abdominopelvic adhesions (P＜0.000 01). Both hyaluronic acid membrane (P＜0.000 01) and hyaluronic acid gel (P＜0.000 01) could reduce the extent of postoperative adhesions. Meanwhile,both hyaluronic acid membrane (P＜0.000 01) and hyaluronic acid gel(P＜0.000 01) could alleviate the severity of postoperative adhesions. The two groups had no statistical difference in total incidence of adverse reactions (P=0.07). CONCLUSION Hyaluronic acid can reduce the incidence of postoperative abdominopelvic adhesions and decrease the extent and severity of postoperative adhesions,with low incidence of adverse reactions. Patients can benefit form hyaluronic acid if it is applied to proper indications under standard operation.
关键词
透明质酸 /
腹腔 /
盆腔 /
粘连 /
Meta分析
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Key words
hyaluronic acid /
adhesion /
abdominal /
pelvic /
Meta-analysis
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中图分类号：
R969.4
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参考文献
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