论文部分内容阅读
目的评价不同节段胸交感神经切断术对手汗症患者术后影响的差异。方法计算机检索万方数据库、中国学术期刊全文数据库(CNKI)、中文科技期刊数据库、中国生物医学文献数据库(CBM)、Pub Med、EMbase及Cochrane Library,检索时间从建库至2016年3月。收集胸交感神经切除治疗手汗症的临床研究。评价纳入研究的质量。采用Rev Man5.3软件对收集的资料进行Meta分析。结果最终纳入15项研究,共2 542例患者。纳入的研究包括9篇随机对照研究,3篇队列研究,3篇回顾性研究。Meta分析结果显示,T3交感神经切除患者术后代偿性出汗发生率与T2交感神经切除术患者差异有统计学意义[OR=4.88,95%CI(1.88,12.68),P=0.001];与T2~4节段神经切除患者比较,T3~4节段切除患者术后代偿性出汗发生率降低,且差异有统计学意义[OR=5.13,95%CI(2.91,9.02),P<0.000 01];同时与T3节段比较,T4节段患者术后代偿性出汗及手部干燥发生率降低,且差异有统计学意义[OR=2.91,95%CI(2.06,4.12),P<0.000 01;OR=14.60,95%CI(3.06,69.63),P=0.000 8]。结论胸4节段交感神经切断术能显著降低患者术后代偿性出汗及手部干燥的发生率,提高患者术后生活质量,具有最佳的手术效果。
Objective To evaluate the difference of postoperative impact between different segments of thoracic sympathectomy on hand perspiration. Methods The databases of CNKI, Chinese Science and Technology Periodicals Database, CBM, Pub Med, EMbase and Cochrane Library were searched by computer. The search time was from database construction to March 2016. Clinical study of collecting sympathectomy for palmar hyperhidrosis. Evaluate the quality of the research included. The collected data were analyzed by Meta-analysis using RevMan5.3 software. The results eventually included 15 studies, a total of 2,542 patients. Included studies included 9 RCTs, 3 cohort studies and 3 retrospective studies. Meta analysis showed that the incidence of postoperative compensatory sweating in patients with T3 sympathectomy was significantly different from that in patients with T2 sympathectomy (OR = 4.88, 95% CI, 1.88, 12.68, P = 0.001). Compared with patients with T2 ~ 4 segmental nerve resection, the incidence of postoperative compensatory sweating in patients with T3 ~ 4 segmental resection was significantly lower than that in patients with T2 ~ 4 segmental resection (OR = 5.13, 95% CI 2.91, 9.02), P <0.000 01]. Comparing with T3, the incidence of postoperative compensatory sweating and hand drying in patients with T4 was significantly lower than that in patients with T3 (OR = 2.91, 95% CI, 2.06, 4.12) , P <0.000 01; OR = 14.60, 95% CI (3.06, 69.63), P = 0.0008]. Conclusions Chest 4-segment sympathectomy can significantly reduce the incidence of postoperative compensatory sweating and hand-drying, and improve the postoperative quality of life of patients with the best surgical results.