体外物理振动排石机用于辅助上尿路结石排石疗效的荟萃分析

The efficacy of external physical vibration lithecbole in the assistant treatment of the upper urinary tract residual stones： a meta-analysis

目的对上尿路结石碎石术后运用Friend－Ⅰ型体外物理振动排石机（EPVL）辅助排石的疗效进行荟萃分析。方法检索Pubmed、Medline、Embase、Cochrane图书馆和中国知网光盘数据库从建刊至2016年3月期间的相关文献，收集所有比较上尿路结石碎石术后运用EPVL辅助排石患者与传统排石疗法患者之间疗效差异的随机对照实验（RCT）与半随机对照实验（Quasi－RCT），评价纳入研究质量，提取有效数据，采用Review Manager 5.3软件进行Meta分析。结果根据本研究设定的纳入与排除标准，最终纳入5篇RCT与Quasi－RCT。EPVL组首日排石率明显高于对照组（OR＝4.95, 95% CI：3.35～7.32, P〈0.000 01）；EPVL组1周后（OR＝3.13, 95% CI：1.95～5.04，P〈0.000 01）及两周后（OR＝4.50, 95% CI：2.02～10.00，P＝0.000 2）结石排净率亦明显高于对照组。随访期间EPVL组未出现严重的不良事件。结论现有证据支持在临床中运用EPVL协助上尿路结石碎石术后的排石治疗。然而受限于本研究较小的样本量，能否在临床中常规运用EPVL协助排石治疗仍需要更多高质量、大样本的RCT研究来明确。

ObjectiveTo determine the clinical effect of Friend-Ⅰ External Physical Vibration Lithecbole （EPVL） by Meta-analysis.MethodsPubmed, Embase, Medline, Cochrane Library, Chinese National Knowledge Infrastructure were searched for clinical trials comparing EPVL with the conventional treatment. The quality of included studies was assessed and Meta-analysis was conducted by Review Manager 5.3 software.ResultsFive randomized or Quasi-randomized controlled trials met the inclusion criteria. The first day stone expulsion rate of EPVL group was superior to the control group （OR=4.95, 95% CI： 3.35-7.32, P〈0.000 01）. Both one-week （OR=3.13, 95% CI： 1.95-5.04, P〈0.000 01） and two-week stone free rate （OR=4.50, 95% CI： 2.02-10.00, P=0.000 2） were statistically higher in the EPVL group than that in the control group. No severe adverse event occurred during the follow-up.ConclusionsOur study suggested that EPVL could be the effective treatment for upper urinary tract residual stone. However, more high quality randomized controlled trials are needed to better affirm this.