输尿管镜碎石术术前应用坦索罗辛辅助治疗有效性的Meta分析

Meta Analysis of the Effectiveness of Tamsulosin Adjuvant Treatment Before Ureteroscopic Lithotripsy

目的系统评价输尿管镜碎石手术前使用坦索罗辛作为辅助治疗的有效性。方法通过计算机检索方式,检索Cochrane Library、EMBase、PubMed、万方数据知识服务平台、中国生物医学文献数据库、中国知网和维普网,同时结合其他检索方法,收集关于输尿管镜碎石术术前使用坦索罗辛辅助治疗相关的随机对照实验(RCT),检索时限为建库至2020年1月。使用RevMan 5.3软件进行Meta分析。结果纳入10篇随机对照实验,共1035例患者,Meta分析结果显示,实验组置镜成功率、结石清除率高于对照组[OR=3.44,95%CI(1.83,6.47),P=0.0001]、[OR=4.15,95%CI(2.63,6.53),P<0.00001],手术时间短于[MD=-10.05,95%CI(-17.9,-2.19),P=0.01],手术并发症发生率低于对照组[OR=0.35,95%CI(0.22,0.57),P<0.0001]。结论输尿管镜碎石术术前使用坦索罗辛辅助治疗可增加置镜成功率,提高结石清除率,缩短手术时间,降低手术相关并发症。

Objective To systematically evaluate the effectiveness of tamsulosin as an adjuvant treatment before ureteroscopic lithotripsy.Methods Through computer retrieval methods,the Cochrane Library,EMBase,PubMed,Wanfang Data Knowledge Service Platform,China Biomedical Literature Database,China Knowledge Network and Weipu Network were retrieved,and other retrieval methods were used to collect information about the preoperative use of ureteroscopic lithotripsy a randomized controlled trial(RCT)related to tamsulosin adjuvant therapy,the search time limit was from the establishment of the database to January 2020.Use RevMan 5.3 software for Meta analysis.Results 10 randomized controlled trials with 1,035 patients were included.Meta analysis showed that the success rate of mirror placement and stone clearance rate in the experimental group were higher than those in the control group[OR=3.44,95%CI(1.83,6.47),P=0.0001],[OR=4.15,95%CI(2.63,6.53),P<0.00001],operation time was shorter than[MD=-10.05,95%CI(-17.9,-2.19),P=0.01],surgical complications occur the rate was lower than that of the control group[OR=0.35,95%CI(0.22,0.57),P<0.0001].Conclusion The adjuvant treatment of tamsulosin before ureteroscopic lithotripsy could increase the success rate of endoscopic placement,improve stone removal rate,shorten operation time,and reduce operation-related complications.