Efficacy and safety of negative pressure versus natural drainage after thyroid surgery: A systematic review and meta-analysis.
Efficacy and safety of negative pressure versus natural drainage after thyroid surgery: A systematic review and meta-analysis.
复制标题
甲状腺手术后负压与自然引流的疗效和安全性
DOI：
10.1097/md.0000000000011576
复制
发表时间：
2018-08
期刊：
影响因子：
1.6
通讯作者：
Zhao E
中科院分区：
文献类型：
--
作者：
Li L;Liu W;Tao H;Chen H;Li W;Huang T;Zhao E
背景资料：评价负压引流在甲状腺手术后甲状腺疾病患者中的有效性和安全性是否优于自然引流。方法：我们进行了深入的文献检索，并遵循系统性综述和荟萃分析（PRISMA）声明首选报告项目中描述的标准进行本系统性综述。使用科克伦偏倚风险工具评估偏倚风险。采用GRADE（Grading of Recommendations Assessment，Development and Evaluation）系统对证据体质量进行评价。结果：共纳入13项研究的1195例甲状腺疾病患者。对于未行颈淋巴清扫的甲状腺切除术患者，负压引流组血清肿和伤口感染的风险较低。负压引流组置管时间短，前24 h内产生的液体多于自然引流组。负压引流对再手术率、死亡率和住院时间的影响尚不清楚。结论：对于接受甲状腺切除术和颈清扫术的患者，由于数据稀少，负压引流组和自然引流组之间的差异仍不确定。上述调查结果的证据质量很低。研究的偏倚风险也很严重。因此，需要更多的随机或非随机对照试验和更大的样本量。
Background: To evaluate whether negative pressure drainage has advantage over natural drainage in effectiveness and safety for patients with thyroid disease after thyroid surgery. Method: We performed intensive literature search and followed the standards described in preferred reporting items for systematic review and meta-analysis (PRISMA) statement to conduct this systematic review. Risk of bias was assessed using the Cochrane Risk of bias tool. We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the quality of evidence body. Results: Total 1195 participants with thyroid disease from 13 studies were included. For patients underwent thyroidectomy without neck dissection, negative pressure drainage group has a lower risk of seroma and wound infection. The duration of tube placement was shorter in negative pressure drainage group, which produced more fluid than natural drainage in the first 24-hour period. The effect of negative pressure drainage on reoperative rates, mortality, and length of hospitalization remains unclear. Conclusions: For patients underwent thyroidectomy with neck dissection, the difference between negative and natural pressure drainage groups remains uncertain due to sparse data. The quality of evidence for the above findings is low. The risk of bias for the studies is also serious. Therefore, more randomized or non-randomized controlled trials with larger sample sizes are required.