摘要
目的:系统评价微创经皮肾镜取石术(MPCNL)与标准通道经皮肾镜取石术(SPCNL)治疗普通型肾结石的有效性与安全性。方法:计算机检索Pub Med、Cochrane Liabrary、CNKI、维普、万方数据库,检索时限从1992年1月1日至2015年4月1日。筛选两种方法治疗肾结石的随机对照试验(RCT)并评价文献质量,采用Rev Man5.2软件进行统计学处理。结果:共纳入9个RCT,1017例患者,其中MPCNL组为508例,SPCNL组为509例。结果显示两种通道处理普通肾结石的清除率MPCNL组低于SPCNL组[OR=0.62,95%CI(0.43,0.91),P=0.01];在手术时间方面,MPCNL组手术时间长于SPCNL组[MD=14.23,95%CI(6.30,22.16),P=0.0004];在住院时间、术中出血量、总的并发症方面两者无明显差异,结果分别为[MD=0.88,95%CI(-0.69,2.44),P=0.27]、[MD=-19.87,95%CI(-64.36,24.61),P=0.38]、[OR=1.28,95%CI(0.90,1.84),P=0.17]。结论:清石率方面MPCNL组低于SPCNL组,并且MPCNL的手术时间较长,可能会影响患者的术后恢复,在并发症、住院时间、术中出血量方面两组无明显差异。故在治疗普通型肾结石方面还是倾向于标准通道经皮肾镜取石术。
Objective： To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy（MPCNL） standard channel percutaneous nephrolithotomy（SPCNL） in the treatment of kidney stones. Methods： We searched Pub Med, Cochrane Liabrary, CNKI, VIP,Wangfang database from January 1, 1992 to April 1, 2015. Screening of the two methods of treatment of kidney stones randomized controlled trials（RCT） and quality assessment, using Rev Man5.2 software for statistical analysis. Results： A total of nine RCT, 1017 patients, 508 cases in MPCNL group,509 cases in SPCNL group. The results show： the stones clearance,MPCNL group was lower than SPCNL group [OR=0.62,95%CI（0.43,0.91）,P=0.01]; in terms of operative time, MPCNL group was longer than SPCNL group [MD = 14.23, 95% CI（6.30,22.16）, P = 0.0004]; hospitalization time, blood loss, total complications, were no significant difference between the two group, the results are [MD = 0.88,95% CI（-0.69, 2.44）, P = 0.27], [MD =-19.87,95% CI（-64.36,24.61）, P = 0.38], [OR=1.28,95%CI（0.90,1.84）,P=0.17]. Conclusion： the stone clearance rate：MPCNL group was lower than SPCNL group, the operative time of MPCNL group was longer which may affect postoperative recovery, the complications, hospital stay, blood loss, the two groups had no significant difference.So,we tend to standard channel percutaneous nephrolithotomy in the treatment of common type of kidney stones.
出处
《世界复合医学》
2015年第4期366-372,共7页
World Journal of Complex Medicine
基金
山西省太原市科技项目(11027605)
关键词
微创经皮肾取石术
标准通道经皮肾取石术
肾结石
META分析
minimally invasive percutaneous nephrolithotomy
standard channel percutaneous nephrolithotomy
kidney stones
meta analysis
