摘要
目的:系统评价球囊扩张器(balloon dilatation,BD)在经皮肾镜取石术中的有效性及安全性应用。方法:计算机检索PubMed、Cochrane图书馆、Embase、万方、中国知网全文数据库、CBM数据库、维普数据库(从建库至2019年12月),纳入BD与常用Amplatz扩张器(amplatz dilatation)建立经皮肾碎石通道的随机对照试验(randomized controlled trial)、并对纳入的研究进行质量评价,提取有效数据,采用RevMan 5.3软件进行Meta分析。结果:最终纳入4篇RCT文献,共441例患者。Meta分析结果表明如下。通道建立时间:BD组患者较AD组患者通道时间差异无统计学意义[WMD=-2.49 min,95%CI(-6.25,1.27),P=0.19];血红蛋白变化:BD组患者较AD组患者术中失血少,差异有统计学意义[WMD=-4.95 g/l,95%CI(-7.92,-1.97),P=0.001]。手术时间:结果显示BD组平均手术时间较AD时间缩短,差异有统计学意义[WMD=-17.53 min,95%CI(-32.57,-2.49),P=0.02];结石清除率:BD组患者与AD组患者清石率差异无统计学意义[RR=1.02,95%CI(0.84,1.23),P=0.84];输血率:BD组与AD组之间差异无统计学意义[RR=0.56,95%CI(0.26,1.22),P=0.15]。平均住院时间:结果显示两组平均住院时间差异无统计学意义[WMD=0.54 d,95%CI(-0.87,-0.22),P=0.001]。结论:球囊扩张器较Amplatz扩张器能减少术中出血及缩短手术时间。
Objective To systematically evaluate the efficacy and safety of balloon dilation(BD)in percutaneous nephrolithotomy.Methods PubMed,Cochrane Library,EMBASE,Wanfang,Chinese Net full text database,CBM database and VIP database(from the establishment to December 2019)were searched.Randomized controlled trials(RCTs)of percutaneous nephrolithotomy with BD and Amplatz dilation(AD)were included.The quality of the included studies was evaluated and the effective data were extracted.RevMan 5.3 software was used for meta analysis.Results Four RTCs were eventually included,with a total of 441 patients.The results of meta-analysis are as follows.There was no statistically significant difference in the access time between BD group and AD group[WMD=-2.49 min,95%CI(-6.25,127),P=0.19].Hemoglobin change:the blood loss in BD group was less than that in AD group,and the difference was statistically significant[WMD=-4.95 g/l,95%CI(-7.92,-1.97),P=0.001].Operation time:the results showed that the average operation time of BD group was shorter than that of AD group,and the difference was statistically significant[WMD=-17.53 min,95%CI(-32.57,-2.49),P=0.02].Stone free there was no significant difference in stone free rate between BD group and AD group[RR=1.02,95%CI(0.84,1.23),P=0.84].Transfusion rate:there was no statistically significant difference between BD and AD group[RR=0.56,95%CI(0.26,1.22),P=0.15].Average hospital stay:the results showed that there was no significant difference in the average hospital stay between the two groups[WMD=0.54day,95%CI(-0.87,-0.22),P=0.001].Conclusion Compared with Amplatz dilation,balloon dilation can reduce intraoperative blood loss and shorten operation time.
作者
王宏权
杨佳
张宇
唐国强
李俞润
卢进辉
WANG Hongquang;YANG Jia;ZHANG Yu;TANG Guo-qiang;LI Yu-run;LU Jin-hui(Department of Urology,Fengdu people's hospital,Chongqing,400082,China;Department of Urology,Second People's Hospital,Jiulongpo District,Chongqing,400052,China)
出处
《湖北医药学院学报》
CAS
2021年第1期25-30,共6页
Journal of Hubei University of Medicine
关键词
经皮肾镜取石术
球囊扩张
Amplatz扩张
系统评价
Ppercutaneous nephrolithotomy
Balloon dilatation
Amplatz dilatation
Metal telescopic dilatation
Systematic review
