包皮环套术治疗小儿及青少年包茎或包皮过长的Meta分析  

Plastibell Versus Conventional Circumcision for Phimosis or Redundant Prepuce in Children and Juveniles:A Meta-Analysis

作　　者：李仁举[1,2] 田金徽[1,3] 杨克虎[1,3] 王志平[2] 

机构地区：[1]兰州大学循证医学中心,兰州730000 [2]兰州大学第二医院,兰州730000 [3]兰州大学基础医学院,兰州730000

出　　处：《循证医学》2010年第2期92-97,共6页The Journal of Evidence-Based Medicine

摘　　要：目的评价包皮环套术治疗小儿及青少年包茎或包皮过长的疗效。方法计算机检索VIP、CNKI、万方、CBM、PubMed、CochraneLibrary、SCI及EMBASE数据库,并辅以手工及其它检索,纳入所有比较包皮环套术与包皮环切术治疗小儿及青少年包茎或包皮过长的随机对照试验,两人独立进行筛选及资料提取,根据Cochrane系统评价手册4.2.6质量评价标准进行评价,用RevMan4.2.10软件进行Meta分析。结果纳入5个研究。Meta分析结果显示:与环切术相比,环套术的手术时间短[加权均数差=-19.74,95%可信区间(-23.00,-16.48)]、术中出血少[加权均数差=-7.50,95%可信区间(-8.48,-6.52)]、感染少[比值比=0.30,95%可信区间(0.12,0.75)]、术后外观好[比值比=0.09,95%可信区间(0.04,0.22)]。结论当前证据表明,包皮环套术是一种疗效可靠、并发症少的治疗小儿及青少年包茎包皮过长的微创术式。但鉴于纳入研究的证据强度有限,有必要进一步开展高质量、大样本的随机临床对照试验评价予以证实。Objective To evaluate the efficacy of plastibell compared to conventional circumcision for phimosis or redundant prepuce in children and juveniles.Method We searched the related original studies all over the world,and only included randomized controlled trials.PubMed,EMBASE,SCI,the Cochrane Library,CNKI,VIP,CBM and Wanfang were searched and six related journals were hand-searched.Two reviewers independently screened the studies for eligibility,evaluated the quality and extracted the data from the eligible studies,with confirmation by cross-checking.Disagree of opinion was consulted by the third reviewer.Meta-analysis was performed by RevMan 4.2.10 software.Result Five studies involving 1 742 patients were included.In comparison with the conventional technique,fewer time of surgery[WMD=-19.74,95%CI（-23.00,-16.48）],less capability of intraoprative bleeding [WMD=-7.50,95%CI（-8.48,-6.52）],lower postoperative infection [OR=0.30,95%CI（0.12,0.75）] and fewer number of appearance defect [OR=0.09,95%CI（0.04,0.22）] were found in the plastibell group.Conclusion The evidence available indicates that plastibell is an effective and minimally invasive treatment for phimosis or redundant prepuce in children and juveniles.

关 键 词：包茎 包皮过长 包皮环套术 包皮环切术 META分析 

分 类 号：R726.9[医药卫生—儿科]