二次电切与单次电切治疗非肌层浸润性膀胱癌的临床疗效的Meta分析

发布时间：2018-03-03 13:12

本文选题：非肌层浸润性膀胱癌　切入点：二次电切　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:综合评价二次电切和单次电切治疗非肌层浸润性膀胱癌的临床疗效,为指导临床治疗非肌层浸润性膀胱癌选择更合理的治疗方案。方法:本课题在广泛搜索文献的基础上,对已发表的临床对照试验进行Meta分析。通过计算机搜索国外数据库如PubMed、The Cochrane Library、EMbase及国内数据库包括维普数据库、中国知网、万方数据库。时间为从1994年1月至2016年7月间外科手术治疗非肌层浸润性膀胱癌的临床对照研究。由两位研究人员各自独立搜索文献并根据已制定的纳入和排除标准筛选文献,按制定标准筛取文献资料行Meta分析。结果:结果初步共检索出488篇文献,最后纳入13篇临床对照实验,总共有1928例患者的资料进行Meta分析,其中实验组(二次电切)共有819例,对照组(单次电切)有1109例。经过对纳入文献的资料进行数据提取整合并进行Meta分析结果显示:术后肿瘤复发率二次电切组(21.8%)低于单次电切组(44.1%),[OR=0.30,95%CI(0.21,0.43),P0.00001],差异有统计学意义;对于术后肿瘤进展率,二次电切组(5.2%),低于未行二次电切术组(13.8%),[OR=0.44,95%CI(0.24,0.80),P=0.007],差异有统计学意义;手术时间,两种方式没有明显差异,[MD=-9.56,95%CI(-20.6,1.48),P=0.09];留置尿管时间上也没有显著差异,[MD=-1.22,95%CI(-2.72,0.28),P=0.11];手术并发症,[OR=1.51,95%CI(0.95,2.40),P=0.08],P0.05,差异无统计学意义。结论:相对于单次电切术,二次电切术在肿瘤复发率和肿瘤进展率均较低,差异有统计学意义;且在手术时间和留置尿管时间、手术并发症上与单次电切无明显差异,值得临床推广。
[Abstract]:Objective: to evaluate the clinical efficacy of secondary electroresection and single electroresection in the treatment of non-myometrial invasive bladder cancer. In order to guide clinical treatment of non-myometrial invasive bladder cancer, a more reasonable treatment scheme was selected. Meta analysis of published clinical controlled trials was carried out. Foreign databases such as the Cochrane Library EMbase were searched by computer. Wanfang database. Clinical controlled study of surgical treatment of non-myometrial invasive bladder cancer from January 1994 to July 2016. The two researchers independently searched the literature and screened the literature according to the established inclusion and exclusion criteria. Results: a total of 488 literatures were preliminarily retrieved and 13 clinical controlled trials were conducted. A total of 1 928 patients were analyzed by Meta, including 819 patients in the experimental group (secondary electrotomy). There were 1109 cases in the control group (single electrotomy). The results of data extraction and Meta analysis showed that the recurrence rate of tumor in the secondary resection group was lower than that in the single electroresection group (P 0.00001), and the difference was statistically significant. The rate of tumor progression in the secondary electroresection group was significantly lower than that in the non-secondary electroresection group (13.8%, 0.24% 0.80% P 0.007), and there was a significant difference in the operation time, and the operative time was significantly lower than that in the second electroresection group (P 0.007), and the operative time was significantly lower than that in the second electroresection group (P 0.007, 0.24%, 0.24%, P 0.007). There was no significant difference between the two methods [MD-9.56-95CI-20.61.48P0.09]; there was no significant difference in the time of indwelling urethral catheter [MD-1.2295CI-2.72CI-2.72CI-2.72CI-0.28P0.11]; the complications of operation, [OR1.5195CI0.952.40CI0.952.40CI0.952.40] P0.05, had no statistical significance. Conclusion: compared with single electroresection, the rate of tumor recurrence and tumor progression of two electrosurgical procedures is lower. The difference was statistically significant, and there was no significant difference between the operative time and the time of indwelling urethral catheter, the complications of operation and single electroresection, so it is worth popularizing in clinic.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.14

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