论文部分内容阅读
目的系统评价胰肾联合移植(simultaneous pancreas–kidney transplantation,SPK)内分泌门静脉回流和体静脉回流两种术式术后移植物存活率、受者存活率和并发症发生率有无区别。方法计算机检索EMbase(1974～2008.1)、PubMed(1970～2008.1)、Cochrane图书馆(2008年第1期)和中国生物医学文献数据库(1978～2008.1),纳入3篇胰肾联合移植内分泌引流两种术式比较的随机对照试验。采用Cochrane协作网的系统评价方法评价纳入研究质量,并提取有效数据进行统计分析。结果最终纳入3个RCT共401例胰肾联合移植进行评价。Meta分析结果显示:胰腺移植内分泌引流的两种术式之间,仅1个研究(共82例)报道门静脉回流术式的3年和5年移植胰腺存活率优于体静脉回流术式(P=0.03,P=0.05),但所有研究的移植胰腺、移植肾脏及受者的各时间点存活率和各种并发症如排斥反应、移植物血栓形成和感染等发生率差异无统计学意义。结论现有研究结果显示,胰肾联合移植内分泌引流两种术式术后移植物存活率、受者存活率和并发症发生率相同。但由于现有临床研究样本量少,上述结论尚需大样本、长期随访的高质量随机对照研究证实。
Objective To evaluate the survival rate, survival rate and complication rate of postoperative transplant recipients with endoscopic portal venous return and venous return by simultaneous pancreas-kidney transplantation (SPK). Methods Two computer-aided searches of EMbase (1974 ~ 2008.1), PubMed (1970 ~ 2008.1), Cochrane Library (2008) and China Biomedical Literature Database (1978 ~ 2008.1) Randomized controlled trials comparing surgical procedures. The Cochrane Collaboration’s systematic review was used to evaluate the quality of included studies and to extract valid data for statistical analysis. The results were included in the final three RCT 401 cases of pancreas and kidney combined transplantation for evaluation. Meta-analysis showed that only one study (n = 82) reported between pancreatic transplants and endocrine drainage in 3 years and 5-year transplanted pancreatic graft survival was better than that of bovine autograft (P = 0.03, P = 0.05). However, there was no significant difference in the survival rates of allograft pancreas, allograft kidneys and recipients at all time points and the incidence of various complications such as rejection, graft thrombosis and infection. Conclusion The results of the current research show that the survival rate of the recipients and the complication rate of the two kinds of operation after pancreas-kidney combined with endocrine drainage are the same. However, due to the small number of existing clinical studies, the above conclusion still needs a large sample and confirmed by long-term follow-up high-quality randomized controlled studies.