【摘要】 目的用循证医学的方法评价甲状腺和甲状旁腺手术术后常规使用引流能否降低术后血肿、出血、皮下积液、创口感染的发生率和术后住院时间。方法检索MEDLINE、EMBASE、cochrane controlled trial register、中国生物医学文献数据库从1966年1月～2007年4月间发表的有关甲状腺和甲状旁腺手术术后常规使用引流的随机对照临床试验。由2名评价者对入选研究中有关试验设计、研究对象的特征、研究结果等内容独立进行摘录,用RevMan4.2软件进行分析。结果对于甲状腺和甲状旁腺手术术后常规使用引流组和非引流组之间血肿发生率(OR=1.31,95%CI:0.7～2.42,P=0.38)、感染发生率(OR=1.51,95%CI:0.53～4.28,P=0.44)、出血发生率(OR=1.21,95%CI:0.35～4.24,P=0.77)和皮下积液发生率(OR=0.50,95%CI:0.22～1.15,P=0.10)无显著差异性。两组术后住院时间有明显差异(OR=1.29,95%CI:0.69～1.88,P<0.01),引流组的术后住院时间明显延长。结论甲状腺和甲状旁腺手术术后常规使用引流在降低术后相关并发症方面没有益处,会延长术后住院时间。更多还原

【Abstract】 Objective A meta-analysis was performed to assess the routine use of drainage after thyroid and parathyroid surgery with respect to the postoperative hematoma、haemorrhage、wound infection、seroma and hospital stay.Methods Medline、EMBASE、Cochrane Controlled Trials Register and China Biological Medicine Disk from Jan 1966 to Apr 2007 were searched for the randomized controlled trials of the routine use of drainage after thyroid and parathyroid surgery.Eleven studies were enrolled into the analysis.The details about the trial design,characters of the subjects,results of the studies were reviewed by two independent authors and analysed by using Revman4.2 software.Results Compared the drain group with non drain group,the drain group was not associated with significantly lower incidence of hematoma(OR=1.31,95%CI:0.71～2.42,P=0.38) 、wound infection(OR=1.51,95%CI:0.53～4.28,P=0.44)、hemorrhage(OR=1.21,95%CI:0.35～4.24,P=0.77) and seroma(OR=0.50,95%CI:0.22～1.15,P=0.10).Length of hospital stay between the two groups was significantly different(OR=1.29,95%CI:0.69～1.88,P<0.01).Hospital stay was longer in patients with drainage.Conclusions Based on our data of the meta-analysis,the routine use of drainage was no effective in decreasing the rate of postoperative complications after thyroid and parathyroid surgery,and it caused a prolonged postoperative hospital stay.更多还原