Meta-analysis Of Small Needle Knife For Anal Fissure

Objective:The use of evidence-based medicine system evaluation method of needle knife in the treatment of anal fissure RCT(randomized controlled trials)literature review and analysis system Meta,evaluation of curative effect of needle scalpel in the treatment of anal fissure,to provide a scientific basis for the treatment of anal fissure scalpel.Methods:Strict inclusion and exclusion criteria,the Chinese literature database(CNKI,Wanfang,VIP,chief medical network)and English retrieval(PubMed,Embase,Cochrane,Library)network retrieval,sorting and screening of eligible literatures Jadad quality evaluation and related information extraction,and then analyzed the packet comparison and statistics based on the extraction results,heterogeneity test data,calculating the value of I2,the significant heterogeneity of the qualitative analysis,no significant heterogeneity of results was analyzed by Meta.The RR value and its 95%confidence interval were calculated by the categorical data,and the weighted mean difference WMD and its 95%confidence interval were calculated by continuous variables,and the P value was calculated by Z test.Results:This study included 16 articles.According to the outcome of the literature,the results were divided into 5 groups,including the analysis of the quantitative analysis(Meta analysis),and the qualitative analysis(chi square test)of the 10 items.The results showed that there was no statistically significant difference between the two groups:the postoperative pain time,postoperative wound rate,postoperative pain score,hospitalization time.Qualitative analysis results:there was statistical significance:the average postoperative wound bleeding disappeared time and postoperative voiding dysfunction rate,postoperative hematochezia average score,postoperative recurrence rate,postoperative infection rate was not statistically significant;the postoperative wound bleeding rate,average operation time,average bleeding volume,postoperative fecal incontinence patient satisfaction and the incidence rate of postoperative.Conclusions:No significant difference between the surgical effect of needle scalpel and traditional anal fissure,but in the average hospitalization time,postoperative pain,postoperative pain time average disappeared after the average wound healing time and postoperative anal fissure were better than traditional surgery;postoperative wound bleeding in average disappearance time,postoperative voiding rate,postoperative amount of blood,postoperative the infection rate and postoperative recurrence rate may be superior to traditional anal fissure surgery;and in the average operation time,average bleeding volume,bleeding rate,postoperative incontinence rate and patient satisfaction there is not enough data show significant differences.The current domestic anal fissure surgery is still using the traditional surgical knife surgery,needle scalpel has some disadvantages,such as higher demands on the manipulation of the human anatomy,especially if not familiar with local anatomy,improper technique,easy to cause injury in clinical practice is still difficult.Therefore,the needle scalpel as a means of adjuvant therapy in the treatment of anal fissure.Limitations:There is a selection bias of literature retrieval,RCT literature literature is less in quantity,quality is not high,there are design loopholes,improper use of statistical methods statistical bias affect the results,should be treated with caution,the research results and conclusion.