在胰腺手术时进行预防性腹部排水
Chunmu Miao1, Yali Hu1, Guijuan Bai2
1Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
The Cochrane database of systematic reviews
|May 16, 2025
概括
在胰腺手术后使用外科排水仍然存在争议. 关于排水与不排水的使用,以及活跃与被动排水,证据非常不确定,但早期排水可能会减少腹部内感染.
科学领域:
- 胃肠病学和肝病学
- 手术瘤学手术瘤学
- 基于证据的医学基于证据的医学.
背景情况:
- 手术排水通常在胰腺手术后使用,但它们在减少术后并发症中的预防作用仍在争论中.
- 这一柯克伦综述是评估腹部排水在胰腺手术中的益处和危害的更新.
研究的目的:
- 评估胰腺手术后常规腹部排水的有效性和安全性.
- 为了比较不同类型的手术排水管和最佳的排水管移除时间.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 包括12个RCT (2550名参与者),比较排水使用与没有排水,不同类型的排水或排水清除计划.
- 使用Cochrane RoB 1工具评估偏差风险和使用GRADE的证据确定性.
主要成果:
- 关于使用排水器与没有排水器的死亡率和感染率,在胰腺双管切除术和远部胰腺切除术中,证据非常不确定.
- 证据也非常不确定的,比较主动与被动排水在胰腺管切除术后.
- 中等确定性证据表明,在胰腺管切除术后早期清除排水可能会减少腹部内感染,而不是晚期清除.
结论:
- 在胰腺手术中预防性腹部排水的作用需要进一步调查,因为证据高度不确定.
- 早期排水似乎有利于减少腹腔内感染,在特定的胰腺二切除术的情况下.
- 未来的研究应该集中在高质量的RCT上,以澄清最佳排水策略.
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