2μm激光治疗非肌层浸润性膀胱肿瘤的Meta分析

发布时间：2018-03-07 07:03

本文选题：非肌层浸润性膀胱肿瘤　切入点：膀胱肿瘤　出处：《新疆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：系统评价2μm激光与经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBt)治疗非肌层浸润性膀胱肿瘤(non muscle-invasive bladder tumor; NMIBT)的疗效差别,为临床应用提供循证依据。方法：计算机检索PubMed, Ovid, Medline、EMbase、 Cochrane Library、CBM、CNKI、万方数据库、维普数据库、超星数据库,同时辅以手工及其他检索,检索时间从建库截止于2013年9月30日,查找所有比较2μm激光与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱肿瘤的随机对照试验研究。按照拟定的纳入排除标准筛选文献、资料提取和方法学质量评价后,采用RevMan5.2软件进行Meta分析。结果：共纳入4个研究全部为RCT,共310例患者,其中2μm激光组161例,TURBt组149例。Meta分析结果显示①与TURBt组相比,2μm激光组术后术后留置尿管时间短(MD=1.47,95%CI[-232,-0.62)、膀胱冲洗时间短(SMD=-3.61,95%CI[-4.41,-3.13]),术中、术后膀胱刺激发生率低(RR=0.30,95%CI[0.19,0.47])、闭孔神经反射发生率低(RR=0.07,95%CI[0.01,0.34])、膀胱穿孔发生率低(RR=0.09,95%℃CI[0.02,0.45)；②两种术式在手术时间、术后住院时间、术后尿道狭窄发生率及术后短期膀胱肿复发率方面差异无明显统计学意义。结论：2μm激光与经尿道膀胱肿瘤电切术相比治疗非肌层浸润性膀胱肿瘤疗效相当,但术后膀胱冲洗时间、留置尿管时间短,术中、术后膀胱刺激、闭孔神经反射、膀胱穿孔发生率低,因此是一项疗效确切,安全性相对较高的微创技术。受纳入研究质量的限制和可能存在发表偏倚的影响,上述结论尚需更多高质量随机对照试验加以验证。
[Abstract]:Objective: to evaluate the efficacy of 2 渭 m laser and transurethral resection of bladder tumor TURBt in the treatment of non muscle-invasive bladder tumor (NMIBT). Methods: to provide evidence-based basis for clinical application. Methods: computer search was conducted for PubMed, Ovid, Medline Embase, Cochrane Library CBMN CNKI, Wanfang database, Weip database, superstar database, accompanied by manual and other retrieval. The retrieval time was from September 30th 2013 to September 30th 2013. All randomized controlled trials comparing 2 渭 m laser and transurethral resection of bladder tumors for non-myometrial invasive bladder tumors were studied. RevMan5.2 software was used to analyze Meta. Results: all of the 4 studies were performed in 310 patients. In 2 渭 m laser group, 161 cases of TURBt group (149 cases). Meta-analysis results showed that 1 compared with TURBt group, postoperative indwelling time of urinary catheter in 2 渭 m laser group was shorter than that in 2 渭 m laser group. The duration of indwelling urinary catheter was 1.47% 95 CI [-232 卤0.62], bladder irrigation time was shorter than that of SMD-3.61 95 CI [-4.41 卤3.13]. The incidence of postoperative bladder irritation was 0.3095 CI [0.190.47], the incidence of obturator nerve reflex was low, the incidence of bladder perforation was 0.07 ~ 95CI [0.01U 0.34], and the incidence of bladder perforation was 0.0995% CI (0.020.45C CI). There was no significant difference in the incidence of postoperative urethral stricture and the recurrence rate of postoperative short-term bladder tumor. Conclusion compared with transurethral resection of bladder tumor, the curative effect of 2 渭 m laser is comparable to that of transurethral resection of bladder tumor. However, the duration of bladder irrigation after operation, the time of indwelling urethral catheter is short, the rate of bladder stimulation, obturator nerve reflex and bladder perforation is low during the operation, so it is an effective method. Minimally invasive techniques with relatively high safety. These conclusions need to be verified by more high quality randomized controlled trials, which are limited by the quality of inclusion studies and may be subject to publication bias.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.14

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