SonixGPS导航系统与传统B超引导穿刺在经皮肾镜碎石术中疗效的Meta分析

Meta analysis of the effect of SonixGPS navigation system and traditional B-ultrasound-guided puncture in percutaneous nephrolithotripsy

目的系统评价SonixGPS引导穿刺定位系统与传统超声引导穿刺在经皮肾镜碎石术(PCNL)的临床应用优越性。方法计算机检索PubMed、EMbase、Cochrane Library、知网、万方数据库,搜集从建库起至2019年12月SonixGPS引导穿刺与传统超声引导在PCNL中安全性及有效性比较的回顾性研究及随机对照试验(RCT)相关的文献。由两名参与研究人员独立筛选文献、提取资料并评价纳入研究的偏倚风险后进行Meta分析。结果共纳入7个研究,包括4项病例对照研究及3项RCT,共计672例上尿路结石患者,其中SonixGPS引导组334例,传统超声组338例。Meta分析结果显示:与传统超声组比较,SonixGPS引导组的手术时间缩短(MD=-15.31,95%CI:-18.71~-11.91,P<0.001),穿刺时间缩短(MD=-2.03,95%CI:-2.54~-1.52,P<0.001)。SonixGPS引导组的一次穿刺成功率更高(MD=6.79,95%CI:3.12~14.75,P<0.001)、结石清除率更高(MD=1.84,95%CI:1.13~2.98,P=0.010),术中出血量减少(MD=-0.58,95%CI:0.31~1.08,P=0.090)。结论与传统超声引导相比,SonixGPS系统在手术时间、穿刺时间、一次穿刺成功率、结石清除率等方面更有优势。

Objective To evaluate the clinical advantages of SonixGPS guided puncture positioning system and traditional ultrasound-guided percutaneous nephrolithotripsis(PCNL).Methods A computer search was conducted on PubMed,EMbase,Cochrane Library,CNKI and Wanfang databases to collect literatures related to retrospective studies and randomized controlled trials(RCT)on the safety and effectiveness of SonixGPS-guided puncture compared with traditional ultrasound guidance in PCNL from the establishment of the database to December 2019.A Meta-analysis was performed by two participating researchers after independent literature screening,data extraction and evaluation of the risk of bias in the included studies.Results A total of 7 studies were included,including 4 case-control studies and 3 RCT,with a total of 672 patients with upper urinary tract stones,including 334 patients in the SonixGPS guided group and 338 patients in the traditional ultrasound group.The results of Meta-analysis showed that compared with traditional ultrasound group,the operation time and puncture time in the SonixGPS guided group were shortened(MD=-15.31,95%CI:-18.71~-11.91,P<0.001)and the puncture time were shortened(MD=-2.03,95%CI:-2.54~-1.52,P<0.001).In the SonixGPS guided group,the success rate of one puncture was higher(MD=6.79,95%CI:3.12~14.75,P<0.001),and the stone clearance rate was higher(MD=1.84,95%CI:1.13~2.98,P=0.010),intraoperative blood loss decreased(MD=-0.58,95%CI:0.31~1.08,P=0.090).Conclusions Compared with traditional ultrasound guidance,SonixGPS system has better operation time,puncture time,one puncture success rate,stone clearance rate and other aspects.