ABSTRACT
Objective To assess the efficency and safety of non-peritoneal drain versus peritoneal drain after appendectomy of severe appendicitis. Methods Randomized controlled trials (RCTs) or quasi-randomize controlled trials(QRCTs) were searched and identified from CNKI (1994 to Oct 2008) ,CBM (1978 to Oct 2008), VIP (1989 to Oct 2008), Wanfang Data (1997 to Oct 2008), MEDI.INE (1966 to Oct 2008), EMBASE (1974 to Oct 2008),The Cochrane Library (issue3, 2008) and SCI (1974 to Oct 2008), and related journals were also scanned. We evaluated the quality of the included studies by Jadad scale and analyzed the data by Cochrane Collaboration' s RevMan 5. 0. Results We included 15 randomized controlled trials or quais-randomized controlled trials (n = 2809). Meta analysis showed that there were statisticly differences between two groups on the incidence of wound infection [OR = 0.43,95%CI (0.29,0.65)], postoperative intestinal adhesion [OR = 0.26,95%CI(0. 18,0.37)]and the duration of hospital stay [WMD = - 0.38,95%CI(- 4.96, - 1.20)], but no difference was found on the incidence of abscesses [OR = 0. 77,95% CI(0. 39, 1. 51)]. Conclusions The current evidences show that contrast with peritoneal drain, the non-peritoneal drain can significantly reduce the incidence of wound infection and intestinal adhesion, and shorten the duration of hosipital stay. Before draw the conclution into clinical practice, further high-quality, large scale, double-blind randomized controlled trials are still needed.
ABSTRACT
Objective To explore the role of adjustable and close persistent peritoneal drain in large ascites and acute renal insufficiency(ARI)in patients with primary nephrotic syndrome(PNS).Methods The adjustable and close persistent peritoneal drain tube were planted in 6 cases with PNS accompanied by large ascites and ARI during December 2005 and August 2006.On the basis of drain,they were treated by prednisone,anticoagulative agent,hypolipidic agent,antibiotics,antioxidant,microcirculation-improving agent and aweto preparation.Results After the treatment,ascites disappeared or decreased.ARI was cured in 5 cases.Among these patients,partial remission(PR)and no respone(NR)to treatment were present in 3 cases respectively during hospitalization.After the follow-up of 3~12 months,the complete remisson(CR)of PNS was found in 2 cases,PR in 3 cases and NR in 1 case respectively.Conclusion The adjustable and close persistent peritoneal drain may be applicable for PNS patients with large ascites and ARI and slight glomerular lesion.It can clear away the superabundant water,mitigate the renal interstitial edema and accelerate the recovery of ARI.It also makes the patients have the opportunity of the treatment which includes predenisone,anticoagulative agent and hypolipidic agent.