骶神经调控术对神经源性膀胱疗效的Meta分析

Sacral neuromodulation effective for neurogenic bladder:a Meta-analysis

目的采用Meta分析评价骶神经调控术(SNM)对神经源性膀胱(NB)的疗效,为临床提供关于NB治疗选择的参考。方法通过检索PubMed及知网数据库,收集国内外2010年1月—2022年12月有关SNM治疗NB的文献,按照纳入排除标准筛选文献,并进行质量评价,提炼数据后采用Review Manager 5.3统计软件进行分析。结果共纳入14项研究、601例患者。Meta分析结果示:SNM对NB患者的排尿次数(WMD=4.30,95%CI:2.84~5.77,P<0.01)、每日尿失禁发作次数(WMD=2.92,95%CI:2.76~3.07,P<0.01)、单次排尿量(WMD=-113.93,95%CI:-159.91~-67.98,P<0.01)、最大尿流率(WMD=-3.23,95%CI:-4.04~-2.42,P<0.01)、残余尿(WMD=111.79,95%CI:79.93~143.64,P<0.01)、最大膀胱容量(WMD=-65.63,95%CI:-84.38~-46.88,P<0.01)以及膀胱顺应性(WMD=-4.65,95%CI:-8.75~-0.55,P=0.03)有显著改善。结论SNM治疗NB的有效性较好,但需要更多随机对照试验的支持。

Objective To evaluate the efficacy of sacral neuromodulation(SNM)in the treatment of neurogenic bladder(NB)with Meta-analysis,so as to provide reference for clinical treatment options for NB.Methods Relevant literatures regarding the efficacy of SNM in treating NB during Jan.2010 and Dec.2022 were collected from the PubMed and CNKI databases,and screened with inclusion and exclusion criteria.After the quality of literatures was assessed,data were extracted and then analyzed using Review Manager 5.3.Results The research included 14 studies involving 601 patients.Meta-analysis showed that SNM significantly improved urinary frequency(WMD=4.30,95%CI:2.84-5.77,P<0.01),daily episodes of urinary incontinence(WMD=2.92,95%CI:2.76-3.07,P<0.01),single void volume(WMD=-113.93,95%CI:-159.91--67.98,P<0.01),maximum flow rate(WMD=-3.23,95%CI:-4.04--2.42,P<0.01),residual urine(WMD=111.79,95%CI:79.93-143.64,P<0.01),maximum bladder capacity(WMD=-65.63,95%CI:-84.38--46.88,P<0.01),and bladder compliance(WMD=-4.65,95%CI:-8.75--0.55,P=0.03).Conclusion SNM is effective in the treatment of NB,but more randomized controlled trials are needed to verify the efficacy.