体外物理振动排石用于辅助体外震波碎石/逆行输尿管软镜碎石术后排石疗效的荟萃分析

doi:10.19558/j.cnki.10-1020/r.2021.05.004

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (3434 KB) RICH HTML
输出: BibTeX | EndNote (RIS)

摘要 目的:系统评价体外物理振动排石 (EPVL)辅助体外震波碎石（ESWL）或逆行输尿管软镜碎石（RIRS）术后排石的有效性与安全性,并进一步探讨其用于术后排石的最佳时机。方法:检索Pubmed、Embase、Cochrane Library、万方、维普、中国知网及中国生物医学文献在线数据库,收集有关EPVL辅助术后排石的随机对照试验(RCTs)。由2名研究者独立进行文献筛选和资料提取,然后参照Cochrane偏倚风险评估工具对纳入文献进行质量评价,采用RevMan5.3软件进行meta分析。结果:最终纳入7篇RCTs,共计946例患者,EPVL组463例,自然排石组483例。Meta分析结果提示,排石治疗后各时期,EPVL组的结石清除率(SFR)均明显高于自然排石组、RIRS亚组,排石治疗后3~5周,EPVL组的尿白细胞阳性率和血尿发生率均明显低于自然排石组。结论:EPVL用于辅助ESWL/RIRS术后排石,能够显著提高清石率,减少术后并发症。为获得较高SFR,减少术后并发症,同时避免过度医疗,我们推荐ESWL/RIRS术后1周根据结石排出情况,对患者辅以EPVL治疗。

	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
	李强
	许长宝
	赵兴华
	李武学
	王若凡

关键词 ：肾结石, 术后残石, 体外物理振动排石, 荟萃分析

Abstract：Objective: To evaluate the efficacy and safety of external physical vibration lithecbole （EPVL）in assistant treatment of residual stones after ESWL/RIRS by meta-analysis, and to explorethe best operation time. Methods: Several online databases including Pubmed, Embase, Cochrane Library, CNKI, VIP, CBM and Wanfang were searched to collect the clinical randomized controlled trials （RCTs） comparing EPVL with the conventional treatmentafter ESWL/RIRS. The data were screened and extracted by two independent reviewers respectively, and the quality of the included articles was evaluated with the Cochrane Collaboration's tool for assessing risk of bias. Then the meta-analysis was conducted with the software of Revman 5.3. Results: 7 RCTs were obtained with 946 cases including the treatment group （n =463） and the control group （n = 483）. The results of meta-analysis showed that the stone-free rate （SFR） ofthe treatment group was significantly higher than that of the control group at each period after lithotripsy. In RIRS subgroup, 3-5 weeks after lithotripsy, the positive rate of urinary leukocyte and hematuria in the treatment group were significantly lower than those in the control group. Conclusion: EPVL is used to assist the removal of stones after ESWL/RIRS, which can significantly improve the SFR and reduce postoperative complications. In order to obtain higher SFR, reduce postoperative complications and avoid excessive medical treatment, we recommend that one week after ESWL/RIRS, EPVL should be used to treat the patients according to the stone excretion.

Key words： kidney stone the residual stone external physical vibration lithecbole meta-analysis

收稿日期: 2021-03-31

基金资助:河南省医学科技攻关计划项目（LHGJ20190322）

通讯作者: 赵兴华,xiaoxin2199@126.com

引用本文:

李强, 许长宝, 赵兴华, 李武学, 王若凡. 体外物理振动排石用于辅助体外震波碎石/逆行输尿管软镜碎石术后排石疗效的荟萃分析[J]. 微创泌尿外科杂志, 2021, 10(5): 304-311.
LI Qiang, XU Changbao, ZHAO Xinghua, LI Wuxue, WANG Ruofan. The efficacy of external physical vibration lithecbolein assistant treatment of residual stonesafter ESWL/RIRS: a meta-analysis. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(5): 304-311.

链接本文:

http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1701.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2021/V10/I5/304

[1] SOROKIN I, MAMOULAKIS C, MIYAZAWA K, et al.Epidemiology of stone disease across the world. World J Urol,2017,35(9):1301-1320.
[2] ZENG G, MAI Z, XIA S, et al.Prevalence of kidney stones in China: an ultrasonography based cross-sectional study. BJU Int,2017,120(1):109-116.
[3] LIU Y, CHEN YT, LIAO BH, et al.Epidemiology of urolithiasis in Asia. Asian J Urol,2018,5(4, SI):205-214.
[4] SCALES J, SMITH AC, HANLEY JM, et al.Prevalence of kidney stones in the United States. Eur Urol,2012,62(1):160-165.
[5] HUANG WY, CHEN YF, CARTER S, et al.Epidemiology of upper urinary tract stone disease in a Taiwanese population:a nationwide,population based study. J Urol,2013,189(6):2158-2163.
[6] HEERS H, TURNEY BW.Trends in urological stone disease: a 5-year update of hospital episode statistics. BJU Int,2016,118(5):785-789.
[7] BAUER J, KAHLMEYER A, STREDELE R, et al.Inpatient therapy of urinary stones in Germany: development of the G-DRG system. Urologe A,2014,53(12):1764-1771.
[8] PREZIOSO D, ILLIANO E, PICCINOCCHI G, et al.Urolithiasis in Italy: an epidemiological study. Arch Ital Urol Androl,2014,86(2):99-102.
[9] ALEXANDER RT, HEMMELGARN BR, WIEBE N, et al.Kidney stones and kidney function loss:a cohort study.BMJ,2012,345:e5287.
[10] EL-ZOGHBY ZM, LIESKE JC, FOLEY RN, et al.Urolithiasis and the risk of ESRD. Clin J Am Soc Nephrol,2012,7(9):1409-1415.
[11] MAO S, JIANG H, WU Z, et al.Urolithiasis: the most risk for nephrectomy in nonrenal tumor patients. J Endourol,2012,26(10):1356-1360.
[12] PEARLE MS, CALHOUN EA, CURHAN GC, et al.Urologic diseases in America project: urolithiasis. J Urol,2005,173(3):848-857.
[13] ASSIMOS D, KRAMBECK A, MILLER NL, et al.Surgical management of stones:American urological association/endourological society guideline,PART II. J Urol,2016,196(4):1161-1169.
[14] TÜRK C, PETŘÍK A, SARICA K, et al. EAU guidelines on interventional treatment for urolithiasis. Eur Urol,2016,69(3):475-482.
[15] 郭应禄,那彦群,叶章群,等.中国泌尿外科和男科疾病诊断治疗指南(2019版).北京:科学出版社,2019: 237-267.
[16] CHUNG DY, KANG DH, CHO KS, et al.Comparison of stone-free rates following shock wave lithotripsy, percutaneous nephrolithotomy, and retrograde intrarenal surgery for treatment of renal stones: A systematic review and network meta-analysis. PLoS One,2019,14(2):e0211316.
[17] IREMASHVILI V, LI S, PENNISTON KL, et al.Role of residual fragments on the risk of repeat surgery after flexible ureteroscopy and laser lithotripsy: single center study. J Urol,2019,201(2):358-363.
[18] BURGHER A, BEMAN M, HOLTZMAN JL, et al.Progression of nephrolithiasis: long-term outcomes with observation of asymptomatic calculi. J Endourol,2004,18(6):534-539.
[19] KOH LT, NG FC, NG KK.Outcomes of long-term follow-up of patients with conservative management of asymptomatic renal calculi. BJU Int,2012,109(4):622-625.
[20] MAITREY PD, YALLAPPA S, METCALFE J, et al.The natural history of asymptomatic calyceal stones. BJU Int,2018,122(2):263-269.
[21] 许长宝,王友志,褚校涵,等.物理振动排石机在上尿路结石体外冲击波碎石后的临床应用.中华泌尿外科杂志,2013,34(8):599-602.
[22] 杨嗣星,叶章群.上尿路结石排石治疗理念的革新:由被动排石变主动排石.中华泌尿外科杂志,2017,38(9):654-657.
[23] 张若晨,秦鑫,刘志洪,等.体外物理振动排石机用于辅助上尿路结石排石疗效的荟萃分析.中华医学杂志,2016,96(38):3094-3098.
[24] PENG L, WEN J, ZHONG W, et al.Is physical therapy effective following extracorporeal shockwave lithotripsy and retrograde intrarenal surgery: a meta-analysis and systematic review. BMC Urol,2020,20(1):93.
[25] XU ZH, ZHOU S, LV JL, et al.Effect of the external physical vibration lithecbole on the discharge of upper urinary stones: a systematic review and meta-analysis. Urol J,2021,18(1):19-27.
[26] YUAN C, JIAN Z, JIN X, et al.Efficacy and safety of external physical vibration lithecbole after extracorporeal shock wave lithotripsy or retrograde intrarenal surgery for urinary stone: a systematic review and meta-analysis. J Endourol,2021,35(5):712-720.
[27] LONG Q, ZHANG J, XU Z, et al.A prospective randomized controlled trial of the efficacy of external physical vibration lithecbole after extracorporeal shock wave lithotripsy for a lower Pole renal stone less than 2 cm. J Urol,2016,195(4 Pt 1):965-970.
[28] TAO RZ, TANG QL, ZHOU S, et al.External physical vibration lithecbole facilitating the expulsion of upper ureteric stones 1.0 cm after extracorporeal shock wave lithotripsy:a prospective randomized trial.Urolithiasis,2020,48(1):71-77.
[29] WU W, YANG Z, XU C, et al.External physical vibration lithecbole promotes the clearance of upper urinary stones after retrograde intrarenal surgery: a prospective, multicenter, randomized controlled trial. J Urol,2017,197(5):1289-1295.
[30] WU WQ, YANG Z, TANG FL, et al.How to accelerate the upper urinary stone discharge after extracorporeal shockwave lithotripsy (ESWL) for < 15 mm upper urinary stones: a prospective multi-center randomized controlled trial about external physical vibration lithecbole (EPVL) World J Urol,2018,36(2):293-298.
[31] 廖文彪,张丽萍,余娅兰,等.软镜钬激光碎石术后采用物理振动排石促进残石排出的疗效分析——单中心随机对照研究.临床泌尿外科杂志,2017,32(12):926-929.
[32] 王曦堃,王友志,褚校涵,等.物理振动排石治疗输尿管软镜术后残石的临床研究.临床外科杂志,2014,22(11):815-817.
[33] PACE KT, TARIQ N, DYER SJ, et al.Mechanical percussion, inversion and diuresis for residual lower Pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. J Urol,2001,166(6):2065-2071.
[34] TÜRK C, KNOLL T, SEITZ C, et al. Medical expulsive therapy for ureterolithiasis: the EAU recommendations in 2016. Eur Urol,2017,71(4):504-507.
[35] ZIAEE SM, HOSSEINI SR, KASHI AH, et al.Impact of sleep position on stone clearance after shock wave lithotripsy in renal calculi. Urol Int,2011,87(1):70-74.
[36] YE Z, ZENG G, YANG H, et al.Efficacy and safety of tamsulosin in medical expulsive therapy for distal ureteral stones with renal colic: a multicenter, randomized, double-blind, placebo-controlled trial. Eur Urol,2018,73(3):385-391.
[37] MITCHELL MA, WARTINGER DD.Validation of a functional pyelocalyceal renal model for the evaluation of renal calculi passage while riding a roller coaster. J Am Osteopath Assoc,2016,116(10):647-652.
[38] SCHMIDT S, WILHELM K.Percussion, diuresis, and inversion therapy for the passage of lower Pole kidney stones following shock wave lithotripsy. Urologe A,2015,54(11):1609-1612.
[39] D'A HR, LUYMES J, WEIR MJ, et al. Mechanical percussion inversion can result in relocation of lower Pole stone fragments after shock wave lithotripsy. Urology,2000,55(2):204-206.
[40] ZHANG Y, XU C, WANG Y, et al.When is the best time to perform external physical vibration lithecbole (EPVL) after retrograde intrarenal surgery (RIRS):a multi-center study based on randomized controlled trials. Urolithiasis,2020,48(6):533-539.