绿激光选择性汽化术治疗非肌层浸润性膀胱肿瘤的疗效及安全性的meta分析

发布时间：2018-03-18 07:47

本文选题：非肌层浸润性膀胱癌　切入点：经尿道膀胱肿瘤切除术　出处：《山西医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:利用meta分析的优势,更加高效客观的评价绿激光选择性膀胱肿瘤汽化术(PVBT)与经尿道膀胱肿瘤切除术(TURBT)治疗非肌层浸润性膀胱肿瘤(NMIBC)的术后疗效及手术的安全性。方法:选取发表于国内外核心期刊上的2006~2015年的文献,对比PVBT与TURBT两种术式治疗的NMIBC的临床对照试验,严格按照纳入排除标准提取相关指标数据,并应用Meta分析的方法评价手术的安全性及术后疗效。结果:最终共有14篇文献符合纳入标准,总研究样本量1680例,PVBT组761例,TURBT组919例。Meta分析结果:PVBT组比TURBT组术后复发率低[OR 0.39,95%CI0.27-0.56,P0.0001]。PVBT组与TURBT组两种术式手术时间无明显差别[p0.05]。PVBT组术后住院时间比TURBT组短[SMD-2.53 d,95%CI-3.61-(-1.44)d,P0.0001]。PVBT组手术出血量比TURBT组少[SMD-18.16 ml,95%CI-19.65-(-16.66)ml,P0.0001]。PVBT组术后尿管留置时间比TURBT组短[SMD-2.60 d,95%CI-3.42-(-1.77)d,P0.0001]。PVBT组术后膀胱冲洗时间比TURBT组短[SMD-1.23,95%CI-1.35-(-1.12),P0.0001]。PVBT组手术并发症发生率比TURBT低[OR 0.06,95%CI 0.03-0.12,p0.0001]。结论:对于NMIBC的治疗,PVBT术较TURBT术不会增加手术时间,并且表现出在手术安全性指标较经典的TURBT术式有一定优势,更为重要的是,PVBT术可能会有助于降低NMIBC术后的复发率。
[Abstract]:Objective: to utilize the advantage of meta analysis, To evaluate the efficacy and safety of green laser selective vaporization of bladder tumor (PVBT) and transurethral resection of bladder tumor (TURBT) in the treatment of non-muscular invasive bladder tumor. The literature from 2006 to 2015 in internal and external core journals, The clinical controlled trials of NMIBC treated with PVBT and TURBT were compared, and the relevant index data were extracted strictly according to the inclusive exclusion criteria. Meta analysis was used to evaluate the safety and efficacy of the operation. Results: a total of 14 articles met the inclusion criteria. The results of Meta-analysis showed that the recurrence rate of TURBT group was lower than that of TURBT group [OR 0.3995 CI0.27-0.56P 0.0001] .There was no significant difference between PVBT group and TURBT group. The postoperative hospitalization time of PVBT group was shorter than that of TURBT group [SMD-2.53 d95CI-3.61-1.44d#en0# P0.0001]. The postoperative urinary catheter retention time in the PVBT group was shorter than that in the TURBT group [SMD-2.60 d95CI-3.42-1.77dP0.0001]. The postoperative bladder irrigation time in the PVBT group was shorter than that in the TURBT group [SMD-1.2395CI-1.35-P0.0001]. The incidence of postoperative complications in the PVBT group was lower than that in the TURBT group [OR 0.0695 CI 0.03-0.12p 0.0001]. Conclusion: the duration of postoperative bladder irrigation in the PVBT group is not longer than that in the TURBT group [SMD-1.2395CI-1.35-P0.0001]. The incidence of postoperative complications in the PVBT group is lower than that in the TURBT group [OR 0.0695 CI 0.03-0.12p 0.0001]. The results also showed that there were some advantages in the safety index of operation compared with the classical TURBT operation, and more importantly, it might be helpful to reduce the recurrence rate of NMIBC.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.14

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