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目的:系统评价生物可吸收防粘连膜预防术后盆腹腔粘连的有效性及安全性。方法:计算机全面检索Pub Med数据库、Spring数据库、OVID数据库、CBM数据库、CNKI数据库、万方数据库,查找关于生物可吸收防粘连膜(HC-CMC)预防术后盆腹腔粘连的有效性及安全性的随机对照文献,检索时限2000年2月至2015年3月。按纳入和排除标准进行文献筛选、资料提取和质量评价后,采用Rev Man 5.3软件进行Meta分析。结果:最终共纳入7篇RCT文章。Meta分析结果显示,试验组与对照组的术后盆腹腔粘连、粘连严重程度2级和3级、粘连范围2级和3级的发生率比较,差异均有统计学意义;粘连严重程度1级和粘连范围1级的发生率比较,差异均无统计学意义(P=0.82,P=0.1)。试验组与对照组的术中出血量比较,差异有统计学意义(P<0.00001);而术后肠梗阻、盆腹腔脓肿、伤口感染、高热的发生率比较,差异均无统计学意义。结论:手术中应用生物可吸收防粘连膜可降低盆腹腔粘连的发生率,减轻粘连严重程度,减少粘连范围,减少术中出血量,然而术后肠梗阻、盆腹腔脓肿、伤口感染及术后高热的发生率相似。
Objective: To systematically evaluate the effectiveness and safety of bioabsorbable anti-adhesion membrane in preventing postoperative pelvic adhesions. Methods: The PubMed database, Spring database, OVID database, CBM database, CNKI database and Wanfang database were searched comprehensively to find out the effectiveness and safety of HC-CMC in prevention of pelvic adhesions after operation Of randomized controlled literature, search time from February 2000 to March 2015. According to inclusion and exclusion criteria for literature screening, data extraction and quality evaluation, the use of Rev Man 5.3 software for meta-analysis. Results: A total of 7 RCT articles were included. The results of Meta analysis showed that there was significant difference in the incidence of postoperative pelvic adhesions and adhesions in the experimental group and the control group between the second grade and the third grade, the second grade and the third grade of adhesions, the grade of adhesion was grade 1 There was no significant difference between the two groups (P = 0.82, P = 0.1). There was significant difference between the two groups in the amount of intraoperative blood loss (P <0.00001). There was no significant difference in the incidence of postoperative intestinal obstruction, pelvic abscess, wound infection and hyperthermia between the experimental group and the control group. Conclusion: The application of bioabsorbable anti-adhesion membrane during operation can reduce the incidence of pelvic and abdominal adhesions, reduce the severity of adhesion, reduce the range of adhesion and reduce the intraoperative blood loss. However, postoperative intestinal obstruction, pelvic abscess, wound infection and postoperative The incidence of high fever is similar.