经输尿管软镜取石术与经皮肾镜取石术在肾结石治疗方面的Meta分析

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (7394 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的:系统评价经输尿管软镜取石术与经皮肾镜取石术在肾结石治疗方面的安全性、疗效。方法:计算机检索 PUBMED,CNKI, sciencedirect, Ovid,EBSCO,CBM等相关的数据库,查找2003~2013年公开发表的文献资料,使用Revman 5.2软件完成Meta分析。结果:对最后纳入的11篇文献进行Meta分析,经输尿管软镜取石术组的结石清除率低于经皮肾镜取石术组[OR=0.51, 95%CI(0.36, 0.72),P=0.000 2], 而在手术时间[MD=17.06, 95%CI(2.94, 31.18),P=0.02],住院时间[MD=-1.51,(-1.98,-1.03),P＜0.000 01],术后出血[OR=0.31, 95%CI(0.05, 1.93),P=0.21],术后发热[OR=1.35, 95%CI(0.51, 3.52),P=0.54],术后漏尿[OR=0.26, 95%CI(0.03, 2.45),P=0.24]方面优于经皮肾镜取石术。结论:根据结果显示:经输尿管软镜取石术在治疗肾结石方面安全、可靠,与经皮肾镜取石术相比,在避免并发症方面有一定优势。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：经输尿管软镜取石术, 经皮肾镜取石术, 肾结石, Meta分析

Abstract：Objective:To assess and compare the security, efficacy of percutaneous nephrolithotomy(PCNL) and Flexible ureteroscopic lithotripsy(FURL). Methods:We searched PubMed, CNKI, ScineceDirect, Ovid, EBSCO, CBM and collected relevant literature published beteen 2003-2012. Meta-analysis was performed using the RevMan 5.2 software. Results:Eleven non-randomized controlled trials were inclued. The results of meta-analysis showed that PCNL was better than FURL in stones clearance (OR=0.51, 95%CI[0.36, 0.72], P=0.000 2), But FURL was better the Mean operative time (MD=17.06, 95%CI[2.94, 31.18], P=0.02), the duration of hospitalization(MD=-1.51, [-1.98,-1.03], P＜0.000 01), the postoperative bleeding (OR=0.31, 95%CI[0.05, 1.93], P=0.21), the postoperative pyrexia (OR=1.35, 95%CI[0.51, 3.52], P=0.54), the postoperative leakage of urine (OR=0.26, 95%CI[0.03, 2.45], P=0.24). Conclusions:Flexible ureteroscopic lithotripsy is safe,compared to percutaneous nephrolithotomy, this surgery has some advantages on avoiding compliactions.

Key words： flexible ureteroscopic lithotripsy percutaneous nephrolithotomy renal calculus Meta-analysis

收稿日期: 2013-09-08

ZTFLH:

R692

通讯作者: 武进峰,wujf005@126.com

引用本文:

杨广修, , 武进峰, 付永强, 康云鹏, 张鑫. 经输尿管软镜取石术与经皮肾镜取石术在肾结石治疗方面的Meta分析[J]. 微创泌尿外科杂志, 2013, 2(6): 384-390.
Yang Guangxiu, Wu Jinfeng, Fu Yongqiang, Kang Yunpeng, Zhang Xin. Flexible ureteroscopic lithotripsy versus percutaneous nephrolithotomy for patients with renal calculus:a Meta-analysis. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2013, 2(6): 384-390.

链接本文:

http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1078.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2013/V2/I6/384

[1] Geavlete P. Editorial comment on: Optimizing shock wave lithotripsy in the 21st century. Eur Urol, 2007, 52(2):352-353.
[2]Preminger GM. Management of lower pole renal calculi: shock wave lithotripsy versus percutaneous nephrolithotomy versus flexible ureteroscopy. Urol Res, 2006, 34(2):108-111.
[3]Menon M. Urinary lithiasis: etiology; diagnosis, and medialm an agrement. C ampbell.surology.vol 4.8 the. Philadelphia: Saunders, 2002:3231.
[4]钟文,曾国华.肾下盏结石的微创外科治疗.国外医学泌尿系统分册,2005,25(5):621-624.
[5]Jou YC, Shen JH, Cheng MC. Percutaneous nephrolithotomy with holmium:Yttium-alumiungarnet laser and fiber guider-report of 349 cases. Urology, 2005, 65(3) : 454-458.
[6]Bellman GC, Dacidoff R, Candela J. Tubeless percutaneous renal surgery. Urology, 1997, 157(5):1578-1582.
[7]Saussine C, Lechevallier E, Traxer O. Tubeless PCNL. Prog Urol, 2008, 18(12):901-907.
[8]Jadad AR, Moore RA, Carroll D. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996, 17(1):1-12.
[9]Kjaergard LL, Villumsen J, Gluud C. Quality of randomized clinical trials affects estimates of intervention efficacy. In: Ⅶ Cochrane Colloquium, Rome, 1999:57.
[10]Higgins JPT,Green S,Editors. Cochrane Handbook for Systematic Reviews of Interventions 1 The Cochrane Library,Issue 4, 2006.
[11]Tolga A, Binbay M, Ozgor F, et al. Comparison of percutaneous nephrolithotomy and retrograde flexible nephrolithotripsy for the management of 2-4 cm stones: a matched-pair analysis. BJU Int, 2012, 109(9):1384-1389.
[12]Omer F,Bozkurt OF, Resorlu B, et al. Retrograde intrarenal surgery versus percutaneous nephrolithotomy in the management of lower-pole renal stones with a diameter of 15 to 20 mm. J Endourol, 2011, 25(7):1131-1135.
[13]Wiesenthal JD, Ghiculete D, Dah RJ, et al. A comparison of treatment modalities for renal calculi between 100 and 300 mm2: are shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy equivalent? J Endourol, 2011, 25(3):481-485.
[14]Hyams ES, Shah O. Percutaneous nephrostolithotomy versus flexible ureteroscopy holmium laser lithotripsy: cost and outcome analysis. J Urol, 2009, 182: 1012-1017.
[15]Chung BI, Aron M, Hegarty NJ, et al. Ureteroscopic versus percutaneous treatment for medium-size (1-2-cm) renal calculi. J Endourol, 2008, 22 : 343-346.
[16]Tolga Akman, Binbay M, Ugurlu M, et al. Outcomes of Retrograde Intrarenal Surgery Compared with Percutaneous Nephrolithotomy in Elderly Patients with Moderate-Size Kidney Stones: A Matched-Pair Analysis. J Endourol, 2012, 26(6):625-629.
[17]Kruck S, Anastasiadis AG, Herrmann TR, et al. Minimally invasive percutaneous nephrolithotomy:an alternative to retrograde intrarenal surgery and shockwave lithotripsy. World J Urol, 2013,31(6):1555-1561.
[18]Pan J, Chen Q, Xue W, et al. RIRS versus mPCNL for single renal stone of 2-3 cm: clinical outcome and cost-effective analysis in Chinese medical setting. Urolithiasis, 2013,41(1):73-78.
[19]Resorlu B, Unsal A, Ziypak T, et al. Comparison of retrograde intrarenal surgery, shockwave lithotripsy, and percutaneous nephrolithotomy for treatment of medium-sized radiolucent renal stones. World J Urol, 2013,31(6):1581-1586.
[20]施小东.电子输尿管软镜与经皮肾镜治疗肾结石的疗效比较[硕士学位论文].浙江:宁波大学,2010.
[21]肖克兵,刘晓龙,臧亚晨,等.经皮肾镜碎石取石术与输尿管软镜钬激光碎石术治疗肾结石的临床观察.江苏医药,2013,39(11)1336-1337.
[22]Marshall VF. Fiber optics in urology. J Urol, 1964, 91:110-114.
[23]程跃,施小东,胡嘉盛,等.电子输尿管软镜下钬激光碎石术.中国内镜杂志,2011, 17(2):212-217.
[24]Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones. Eur Urol, 2009, 55(5):1190-1196.