摘要
目的系统评价输尿管软镜治疗输尿管上段结石的有效性和安全性。方法电子检索Medline(1950年1月至2015年8月)、万方数据库(1990年1月至2015年8月)、中国生物医学文献数据库(1978年1月至2015年8月)、Cochrane图书馆临床随机对照试验库(截止2015年第8期)、CNKI数据库和维普中文期刊数据库,收集有关输尿管软镜治疗输尿管上段结石的临床随机对照试验和临床对照试验。两位研究者独立按照临床试验报告统一标准(CONSORT质量评价标准)和非随机研究方法论指数(MINORS量表)对文献进行质量评价并提取数据。结果最终纳入文献8篇,患者799例,其中试验组输尿管软镜取石术(f URL)392例,对照组经皮肾镜取石术(PCNL)407例。Meta合并分析结果显示,f URL相比PCNL可显著缩短术后住院时间(WMD=-2.42,95%CI-2.62^-2.22,P<0.000 01),并减少术后并发症(OR=0.53,95%CI 0.32~0.89,P=0.02),但f URL结石清除率低于PCNL(OR=0.42,95%CI 0.25~0.70,P=0.000 09),且手术时间延长(WMD=22.19,95%CI 20.37~24.01,P<0.000 01)。结论输尿管软镜取石术在减少术后并发症、缩短住院时间的同时降低了结石清除率,并使手术时间延长。
Objective To evaluate the efficacy and safety of flexible ureteroscope lithotripsy for proximal ureteral calculus. Methods The electronic search was conducted in Medline（ OVID,Jan. 1950-Aug.2015）,Wan Fang data（ Jan. 1990-Aug. 2015）,CBM（ Jan. 1978-Aug. 2015） and CENTRAL（ Issue 8,2015）,CNKI and VIP Chinese database. Randomized clinical controlled trials and clinical controlled trials of flexible ureteroscope lithotripsy for proximal ureteral calculus were selected. Two investigators independently evaluated the quality of included trials in accordance with CONSORT and MINORS statement and extracted related data. Results Altogether 8 trials of 799 patients met the inclusion criteria and were enrolled in the trials（ 392 patients in f URL group and 407 patients in control group）. Meta-analysis showed flexible ureteroscopelithtripsy（ f URL） can significantly shorten the duration of hospital stay（ WMD =- 2. 42,95% CI- 2. 62-- 2. 22,P 〈 0. 000 01） and reduce operative complications（ OR = 0. 53,95% CI 0. 32-0. 89,P =0. 02）,but with reduction of the calculi clearance rate（ OR = 0. 42,95% CI 0. 25-0. 70,P = 0. 000 09） and extension of operation time（ WMD = 22. 19,95% CI 20. 37-24. 01,P 〈 0. 000 01）. Conclusion The evidence currently available indicated that f URL is featured with reduced hospital stay,operative complications and calculi clearance rate,and increased operation time.
出处
《医学综述》
2016年第7期1374-1378,共5页
Medical Recapitulate
关键词
输尿管软镜
输尿管上段结石
META分析
系统评价
Flexible ureteroscope
Proximal ureteral calculus
Meta-analysis
Systematic review
