膀胱灌注和经尿道电凝治疗出血性放射性膀胱炎效果的Meta分析

Meta Analysis of the Effects of Bladder Perfusion and Transurethral Electrocoagulation in the Treatment of Hemorrhagic Radiation Cystitis

目的比较膀胱灌注和经尿道电凝治疗出血性放射性膀胱炎的有效性和安全性。方法系统检索EMBASE、Cochrane library、PubMed、中国知网、万方、维普和中国生物医学文献数据库数据库,截至到2020年11月,搜集膀胱灌注和经尿道电凝医治出血性放射性膀胱炎相关文献,运用RevMan 5.3版本进行Meta分析。结果纳入4项RCT和1项回顾性研究,共357例患者,其中经尿道电凝治疗组188例采用经尿道电凝治疗,膀胱灌注治疗组169例采用采用膀胱灌注治疗。Meta分析显示,经尿道电凝治疗组有效率高于膀胱灌注治疗组(RR=1.21,95%CI:1.12~1.31,P<0.00001),复发率低于膀胱灌注治疗组(RR=0.14,95%CI:0.05~0.34,P<0.00001),并发症发生率低于膀胱灌注治疗组(RR=0.17,95%CI:0.07~0.39,P<0.00001),差异有统计学意义(P<0.05)。结论经尿道电凝治疗出血性膀胱炎的疗效优于膀胱灌注,复发率及并发症发生率较低。

Objective To compare the effectiveness and safety of bladder perfusion and transurethral electrocoagulation in the treatment of hemorrhagic radiation cystitis.Methods Systematic search of Embase,Cochrane library,PubMed,CNKI,Wanfang,Weipu and China Biomedical Literature Database,As of November 2020,the literature on bladder perfusion and transurethral electrocoagulation for the treatment of hemorrhagic radiation cystitis has been collected,and the RevMan version 5.3 has been used for meta-analysis.Results Four RCTs and one retrospective study were included.A total of 357 patients were included.Among them,188 patients in the experimental group were treated with transurethral electrocoagulation,and 169 patients in the control group were treated with bladder infusion.Meta analysis showed that the effective rate of the transurethral electrocoagulation treatment group was higher than that of the bladder perfusion treatment group(RR=1.21,95%CI:1.12-1.31,P<0.00001).The recurrence rate was lower than that of the bladder perfusion treatment group(RR=0.14,95%CI:0.05-0.34,P<0.00001),the incidence of complications was lower than that in the bladder perfusion treatment group(RR=0.17,95%CI:0.07-0.39,P<0.00001),the difference was statistically significant(P<0.05).Conclusion The efficacy of transurethral electrocoagulation in the treatment of hemorrhagic cystitis is better than bladder perfusion,and the recurrence rate and complication rate are lower.