摘要
目的通过系统评价比较原位回肠新膀胱(IONB)与回肠膀胱术(IC)对患者术后生活质量的影响。方法检索中国生物医学文献数据库、中国知网、万方和维普中文科技期刊数据库、PubMed、Medline、Embase、The Cochrane Library从2005年1月至2018年4月,采用国际公认生命质量量表对IONB与IC患者进行术后生命质量比较的研究。结果共纳入12篇对照研究,共1207例患者,涉及5种量表:特异性量表(FACT-BL、EORTC QLQ-C30、EORTC QLQ-BLM30、BCI),通用性量表(SF-36)。Meta分析结果显示:IONB患者的总体生活质量优于IC,差异有统计学意义(SMD=0.27,95%CI:0.13~0.41,P=0.0002)。进一步比较膀胱癌特异性量表维度评分,FACT-BL量表:IONB躯体功能(P=0.0007)及功能状况(P=0.04)方面优于IC,情感状况、社会/家庭状况以及膀胱癌特异性模块方面的差异均无统计学意义;EORTC QLQ-BLM30量表:IONB与IC在未来期望,身体形象,腹胀三者的差异均无统计学意义;BCI量表:在泌尿功能的差异有统计学意义(P=0.0005),IC优于IONB,二者在泌尿烦恼的差异无统计学意义。癌症特异性量表维度评分,EORTC QLQ-C30量表:认知功能方面IONB优于IC(P=0.03),在躯体功能、角色功能、情感功能、社会功能、总体生活质量四者的差异均无统计学意义。通用性量表SF-36:生理功能的差异有统计学意义(P=0.003),IONB优于IC,但一般健康状况、躯体角色、情感角色、肌体疼痛、心理健康、精力状态、社会功能的差异均无统计学意义,IONB并不优于IC。结论根据非随机对照证据,膀胱癌根治性全切行IONB较IC术后对患者生活质量的影响有一定优势。
Objective To compare quality of life(QOL)in patients undergoing ileal orthotopic neobladder(IONB)or ileal conduit(IC)after radical cystectomy(RC),through a systematic review and Meta-analysis.Methods All relevant published studies about the comparison between IONB and IC using validated QOL questionnaires were searched,including CBM Disc,CNKI,VIP,Wanfang Data,Pubmed,Medline,Embase,The Cochrane Library,dated from January 2005 to April 2018.Results Twelve controlled studies and 1207 cases were included.Five validated scales were Specific Scale(FACT-BL,EORTC QLQ-C30,EORTC QLQ-BLM30,BCI),General Scale(SF-36).The Meta-analysis outcomes:IONB showed a signifcantly better QOL in patients versus IC(SMD=0.27,95%CI=0.13-0.41,P=0.0002).Further comparison between dimension scores,pooled effects sizes of all FACT-BL aspects only a significant better PWE and FWB in patients with IONB.There were no significant differences in EWB,SWB and BSS.Also no significant differences in aspects of future perspective,abdominal bloating and flatulence,body image between IC and IONB groups using EORTC QLQ-BLM30.Analyzing BCI aspects,urinary function was significantly better in IC patients(P=0.003),no significant in urinary bother.Analyzing EORTC-QLQ-C30 aspects,only CF(P=0.03)was significantly better in patients with IONB.There was no significant in PF,RF,EF,SF and GQOL.Compared with all aspects of SF-36,there was only significant higher scores in PF(P=0.003),IONB was superior to IC.Conclusions According to the not-random evidence,QOL after cystectomy undergoing IONB is superior than IC in some aspects.
作者
周晓菊
周宏
王安静
龙瑶
刘瑶
Zhou Xiaoju;Zhou Hong;Wang Anjing;Long Yao;Liu Yao(Department of Urology,the Second Affiliated Hospital of PLA Army Medical University,Chongqing 400037,China)
出处
《国际泌尿系统杂志》
2020年第1期8-13,共6页
International Journal of Urology and Nephrology
关键词
糖尿病
2型
老年人
女性
膀胱
过度活动性
Cystectomy
Urinary Diversion
Quality of Life
Meta-Analysis
