Efficacy Of Medical Thoracoscopy For Tuberculous Pleural Effusion:A Meta-Analysis

Objectives To systematically review the effectiveness of medical thoracoscopy(MT)in the treatment of tuberculous pleural effusion(TPE).Methods We searched include of Pub Med,EMbase,The Cochrane Library,Web of Science,CNKI,Wan Fang Data,CBM and VIP databases from inception to December 10,2016,to collect randomized controlled trials involving MT in the treatment of tuberculous pleural effusion.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted data and evaluated the methodological quality of the study,and then Meta-analysis was performed using Rev Man 5.3 software.Results A total of 21 studies involving 1858 patients were included.The results of Meta-analysis showed that compared with N-MT,MT in the treatment of TPE in Effectiv eness[OR=15.13,95%CI(8.11,28.23),P<0.00001],total drainage of pleural effusion[MD=465.30,95%CI(273.07,657.54),P<0.00001],pleural effusion fading time[MD=-7.83,95%CI(-11.56,-4.11),P<0.0001],hospital stays[MD=-4.42,95%CI(-7.39,-1.44),P=0.004],lung function FEV1% improvement rate[MD=4.79,95%CI(2.46,7.11),P<0.0001],lung function FVC% improvement rate[MD=6.68,95%CI(4.61,8.76),P<0.00001],pleural thickness[MD=-0.76,95%CI(-0.99,-0.52),P<0.00001],pleural thickening incidence[OR=0.27,95%CI(0.14,0.55),P=0.0003],surgery incide nce[OR=0.24,95%CI(0.15,0.41),P<0.00001],clinical symptoms disappeard time[MD=-5.31,95%CI(-9.09,-1.53),P=0.006],drainage tube removal time[MD=-6.24,95%CI(-6.61,-5.86),P<0.00001],the recurrence rate of encapsulated pleural effusion[OR=0.37,95%CI(0.19,0.72),P=0.003],the difference were statistically sign if icant.But there was no significant difference between the two groups in the incidence of adverse reactions of treatment of encapsulate d tuberculous pleural effusion[OR=0.80,95%CI(0.31,2.03),P=0.63].Conclusion The available existing evidence suggests that MT-assisted in the treatment of TPE is effective and has less complications,worthy of clinical application.In view of the limited number of studies included,the above conclusions still need to conduct more research to verify.