索利那新治疗经尿道前列腺切除术后膀胱痉挛临床效果的Meta分析

Efficacy and safety of solifenacin in the treatment of patients with bladder spasm after transurethral resection of prostate：a systematic review and meta-analysis

目的 根据现有临床证据评价索利那新治疗经尿道前列腺切除术后膀胱痉挛的有效性与安全性.方法 通过计算机检索建库至2016年10月PubMed、EMbase、The Cochrane Library、CBM、CNKI、VIP和Wan Fang Date数据库,根据纳入与排除标准筛选文献、提取资料,并将纳入研究进行方法学质量评价,采用RevMan 5.3软件进行统计分析.结果 共纳入11个随机对照试验（RCT）,共计621例患者.Meta分析结果显示：索利那新组（n=310）的膀胱痉挛次数[MD=-1.38,95%CI（-1.97,-0.97）P〈0.00001]、痉挛持续时间[MD=-0.26,95%CI（-0.41,-0.11）,P=0.0008]、膀胱冲洗转清时间[MD=-0.59,95%CI（-0.88,-0.29）,P〈0.0001]和拔除导尿管时间[MD=-0.29,95%CI（-0.48,-0.11）,P=0.09]均小于对照组（n=311）,差异均有统计学意义.而两组不良反应发生率差异无统计学意义[RR=0.71,95%CI（0.17,2.98）,P=0.64].结论 基于当前证据显示,索利那新治疗经尿道前列腺切除术后膀胱痉挛疗效确切,优于其他常规治疗方法,且安全性好.但鉴于纳入研究的数量和质量有限,上述结论尚需开展更多研究予以验证.

Objective To systematically review the efficacy and safety of solifenacin in the treatment of patients with bladder spasm after transurethral resection of prostate based on current evidence.Methods We searched Pubmed,EMbase,the Cochrane Library,CBM,CNKI,VIP and Wanfang Database from the establishment to October 2016 for the published literature on the treatment of patients with bladder spasm after transurethral resection of prostate with solifenacin.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results A total of 11 RCTs involving 621 patients were included.The results of meta-analysis showed that：compared with the no-solifenacin group（n=311）,the numbers of bladder spasm episodes[MD=-1.38,95%CI（-1.97,-0.97）P〈0.00001],duration of bladder spasm[MD=-0.26,95%CI（-0.41,-0.11）,P=0.0008],the time of bladder perfusion clearance[MD=-0.59,95%CI（-0.88,-0.29）,P〈0.0001],indwelling catheter delivery[MD=-0.29,95%CI（-0.48,-0.11）,P=0.09]in solifenacin group（n=310） reduced significantly,and there was no statistical difference in the incidence of overall adverse events between the two groups[RR=0.71,95%CI（0.17,2.98）,P=0.64].Conclusion Current evidence indicates that solifenacin is more effective and safe in the treatment of patients with bladder spasm after transurethral resection of prostate.Due to the limited quantity and quality of the include studies,more high quality studies are needed to verify the above conclusion.