经尿道前列腺单极和双极切除术治疗前列腺增生症的Meta分析

Monopolar versus bipolar transurethral resection of the prostate ： a Meta analysis

目的用Meta分析的方法系统评价经尿道前列腺单极切除术和双极切除术治疗前列腺增生症的疗效和安全性。方法计算机检索PubMed、EMBASE、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库以及重要的学术论文网站关于单极切除术和双极切除术治疗前列腺增生症的随机对照试验，按照Cochrane handbook制作Meta分析，用RevMan5．2软件统计分析。结果共纳入16篇随机对照试验（共计1986例患者）。Meta分析结果显示：单极切除术和双极切除术两种方法治疗前列腺增生症在最大尿流率[MD=0．34，95％CI（-0．15，0．82）]、输血发生率[RD=0．00，95％CI（-0．01，0．02）]方面差异无统计学意义，而在前列腺切除综合征发生率[RD=0．01，95％CI（0．00，0．03）]、术后血凝块残留发生率[RD=0．03，95％CI（0．01，0．05）]方面差异有统计学意义。结论当前研究证据提示与经尿道前列腺单极切除术相比，双极切除术并不能提高患者的最大尿流率，术后并发症少。

Objectives To systematic review the efficacy and safety of monopolar versus bipolar transurethral resection of the prostate using Meta analysis. Methods PubMed, Embase, the Cochrane Library, Chinese biomedical literature database, Chinese Scientific Journals full -text database, Chi- nese Journal full -text database, and major conference proceeding for randomized controlled trials comparing monopolar with bipolar transurethral resection of the prostate for patients with benign prostatic hyperplasia were searched . Meta anlysis was carry out according to Cochrane handbook. The data were analyzed using Review Manager 5.2 provied by Cochrane collaboration. Results 16 randomized controlled trials （a total of 1986 patients） were included. The Meta analysis showed that there was not significant difference between monopolar group and bipolar group in Qmax [ MD = 0.34,95% CI （ -0. 15,0.82） ] and clot retention incidence rate [ RD = 0.00,95 % CI （ - 0.01,0.02 ） ]. While bipolar group provided lower transurethral resection syndrome rate [ RD = 0.01,95% CI （0.00,0.03） ] and clot retention [ RD = 0.03,95% CI（0. 01,0. 05 ） ]. Conclusions Current clinical evidence indicates that no clinically relevant differences in Qmax exists between the two techniques, bipolar technology is superior to monopolar technology in safety.