摘要
目的系统回顾分析输尿管软镜碎石取石术(RIRS)与超微经皮肾镜碎石取石术(micro-PCNL)处理肾结石(<3 cm)的有效性与安全性。方法通过检索Pubmed、Cochrane图书馆、Embase、中国知网、万方数据库及中国生物医学文献服务系统等数据库(2011-01-01至2017-03-01),获得有关micro-PCNL与RIRS处理中小肾结石的相关临床试验的中英文文献。根据研究纳入及排除标准,对纳入文献提取相关临床试验数据,经Revman 5.0分析软件分析得出结论。结果本研究总共纳入4篇文献,2篇为随机对照试验,2篇为回顾性分析试验,所有文献总共纳入328例患者。RIRS与micro-PCNL的住院时间[WMD=2.71,95%CI(-3.78,9.20)],手术时间[WMD=6.56,95%CI(-22.94,36.05)]、及术后并发症[OR=0.99,95%CI(0.51,1.95)]等差异无统计学意义,而在结石清除率中,micro-PCNL优于RIRS[OR=2.30,95%CI(1.24,4.26)],且差异具有统计学意义。结论两种术式均安全有效,micro-PCNL结石清除率高于RIRS。
Objective To systematically analyze the clinical efficacy and safety of micro-percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in the treatment of kidney stones that measure smaller than 3 cm. Methods Through searching PubMed, Cochrane library, Embase, CNKI, Wanfang database and SinoMed, clinical trials related to micro-PCNL and RIRS in treating small-and medium-size kidney stones in both Chinese and English from January 1, 2011 to March 1, 2017 were retrieved. According to the inclusion and exclusion criteria, relevant clinical trial data were extracted from the literatures and statistically analyzed by Revman 5.0 software to draw a conclusion. Results Four articles consisting of 328 patients were included in this meta-analysis, including two randomized controlled trials and two retrospective trials. No statistical signifcance was noted in terms of the length of hospital stay [(WMD=2.71, 95%CI (-3.78,9.20)], operation time (WMD=6.56, 95%CI (-22.94,36.05)] and postoperative complications [OR=0.99, 95%CI (0.51,1.95)] between RIRS and micro-PCNL, whereas the removal rate of kidney stones by micro-PCNL was signifcantly higher compared with that by RIRS (OR=2.30, 95%CI (1.24,4.26)]. Conclusion Both micro-PCNL and RIRS are effcacious and safe in the treatment of kidney stones, whereas the removal rate of micro-PCNL is considerably higher than that by RIRS.
作者
徐煜宇
袁耀基
黄晨
梁健
李逊
何永忠
杨炜青
徐桂彬
Xu Yuyu;Yuan Yaoji;Huang Chen;Liang Jian;Li Xun;He Yongzhong;Yang Weiqing;Xu Guibin(Department of Urology,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou 510700,China;Graduate School of Guangzhou Medical University,Guangzhou 510000,China)
出处
《中华腔镜泌尿外科杂志(电子版)》
2018年第4期220-223,共4页
Chinese Journal of Endourology(Electronic Edition)
基金
广东省自然科学基金(2015A030310530)
广州市教育局创新团队项目(13C10)
关键词
超微
经皮肾镜
输尿管软镜
肾结石
META分析
Micro
percutaneous nephrolithotomy
Flexible ureteroscope
Kidney stone
Meta-analysis