非复杂性输尿管镜碎石术后留置输尿管支架管必要性的Meta分析

发布时间：2018-03-01 15:32

本文关键词： 输尿管结石输尿管支架管随机对照研究 Meta分析　出处：《临床泌尿外科杂志》2016年07期 　论文类型：期刊论文

【摘要】：目的:评价非复杂性输尿管镜碎石术后常规留置输尿管支架管的必要性。方法:计算机检索中国生物医学文献数据库(CBM)、中国学术期刊网络出版总库(CNKI)、维普资讯中文科技期刊数据库(VIP)和万方数据知识服务平台(WANFANG datebase)、MEDLINE、EMbase、Cochrane图书馆,纳入经输尿管碎石术后留置输尿管支架管的随机对照研究(RCT)。主要评价两组研究对象的手术时间、术后结石清除率、下尿路症状(排尿困难、血尿、尿频)及再入院率、泌尿系感染率。采用RevMan5.2进行Meta分析。结果:共纳入17个RCT,涉及经输尿管镜下碎石研究对象1 323例。Meta分析结果表明,非复杂性输尿管镜碎石术后:(1)两组研究对象手术时间的差异有统计学意义(WMD=3.61,95%CI:1.45~5.76,P=0.001)。(2)两组研究对象结石清除率的差异无统计学意义(RR=0.98,95%CI:0.96~1.00,P=0.09)。(3)两组研究对象排尿困难发生率的差异有统计学意义(RR=2.21,95%CI:1.38~3.53,P=0.0009)。(4)两组研究对象尿频发生率的差异有统计学意义(RR=1.54,95%CI:1.06~2.23,P=0.002)。(5)两组研究对象血尿发生率的差异有统计学意义(RR=1.85,95%CI:1.17~2.90,=0.008)。(6)两组研究对象再入院率的差异有统计学意义(RR=0.42,95%CI:0.23~0.78,P=0.006)。(7)两组研究对象泌尿系感染的差异无统计学意义(RR=0.32,95%CI:0.06~1.62,P=0.17)。结论:非复杂性输尿管镜下碎石术后没有必要常规留置支架管,术后不留置支架管并不影响术后研究对象的结石清除率、泌尿系感染发生率等,但能够缩短手术时间,减少术后下尿路症状发生率及再入院率。
[Abstract]:Objective: to evaluate the necessity of conventional indwelling ureteral stents after non-complex ureteroscopic lithotripsy. VIPs) and Wanfang data and knowledge service platform WANFANG datebase MEDLINEN EMbase Cochrane Library, A randomized controlled study was conducted to evaluate the operation time, postoperative stone clearance rate, lower urinary tract symptoms (dysuria, hematuria, frequency of ureter) and readmission rate of the two groups in a randomized controlled study of indwelling ureteral stents after ureteral lithotripsy. Urinary tract infection rate. RevMan5.2 was used for Meta analysis. Results: a total of 17 RCTs were included, involving 1 323 cases of ureteroscopic lithotripsy. The results of Meta analysis showed that: 1 323 cases were treated with ureteroscopic lithotripsy. The difference of operation time between the two groups was statistically significant. There was no significant difference in stone clearance rate between the two groups. There was no significant difference in the rate of stone removal between the two groups. The incidence of dysuria was significantly different between the two groups (RRN 0.98V 95: 0.961.00P0.09. 3) the incidence of dysuria in the two groups was significantly higher than that in the control group (P < 0.05), and there was no significant difference between the two groups in the incidence of dysuria. There is a significant difference in the incidence of urinary frequency between the two study groups. (RRN 1.5495 CI: 1.06U 2.23CU 0.002U. 5) there is a statistically significant difference in the incidence of hematuria between the two groups. There is a significant difference in the readmission rate between the two groups. There is a significant difference in readmission rate between the two groups (RR1.85 / 95CIW 1.172.90,0.0080.75). There is a statistically significant difference in readmission rate between the two groups. There was no significant difference in urinary tract infection between the two groups. Conclusion: there is no need for conventional stenting after noncomplicated ureteroscopic lithotripsy, and there is no significant difference between RRX 0.32 and 95% CI: 0.061.62P 0.170.Conclusion: there is no need for conventional stenting after noncomplicated ureteroscopic lithotripsy. The rate of stone removal and urinary tract infection were not affected by the non-indwelling stent, but it could shorten the operation time and reduce the incidence of lower urinary tract symptoms and readmission.
【作者单位】：新疆医科大学第二附属医院泌尿外科;
【基金】：国家自然科技基金资助项目(编号81460139)
【分类号】：R699.4

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