经尿道钬激光与经尿道冷刀内切开治疗尿道狭窄疗效比较的Meta分析  

Comparison of therapeutic effect of transurethral holmium laser resection and transurethral cold knife urethrotomy in treatment of urethral stricture:a meta-analysis

作　　者：温辉煌[1] 刘修恒[1] 王伟[1] 王浩[1] 杨一菲[2] 

机构地区：[1]武汉大学人民医院泌尿外科,湖北省武汉市430060 [2]武汉大学人民医院肾脏内科,湖北省武汉市430060

出　　处：《职业与健康》2012年第21期2572-2575,共4页Occupation and Health

摘　　要：目的比较经尿道钬激光与经尿道冷刀内切开2种术式治疗尿道狭窄的疗效。方法采用计算机检索PubMed、Co-chrane图书馆、CNKI、CBM和WANFANG数据库,查找所有比较经尿道钬激光与经尿道冷刀内切开2种术式治疗尿道狭窄的随机对照试验,检索时限均为建库至2012年1月。同时手检纳入文献的参考文献。按纳入排除标准由2人独立进行随机临床试验(RCT)筛选、资料提取和质量评价后,采用RevMan 5.1软件进行Meta分析。结果共纳入5个研究,372例患者。进行Meta分析,比较2种术式的相关疗效指标得出,术后疗效指标差异均有统计学意义。采用钬激光手术的术后最大尿流率[加权均数差(WMD)=4.70,95%CI(2.91,6.50),P<0.01]和术后尿道扩张时间[WMD=-5.00,95%CI(-7.31,-2.69),P<0.01]均大于经尿道冷刀内切开术,再术率[OR=0.19,95%CI(0.11,0.33),P<0.01]低于冷刀内切开术。结论钬激光治疗男性尿道狭窄疗效优于经尿道冷刀内切开联合电切术。但因原始研究较少,且质量均较低,建议临床上审慎选择使用;需要更多高质量、大样本的随机对照试验进一步论证。[Objective] To compare the therapeutic effect of transurethral holmium laser resection and transurethral cold knife urethrotomy in treatment of urethral stricture.[Methods]All randomized controlled trials published until January 2012,which the studies were aimed to compared the therapeutic effect of transurethral holmium laser resection and transurethral cold knife urethrotomy in treatment of urethral stricture,were searched from PubMed,Cochrane library,CNKI,CBM and WANFANG database,and the references were hand searched.According to the inclusion and exclusion criteria,two reviewers independently conducted the randomized clinical trial（RCT） selection,data collection and quality assessment,and a meta-analysis was performed by using the RevMan 5.1 software.[Results]A total of five studies had met the inclusion criteria,and there were 372 cases.The meta-analysis showed that there was significant difference in postoperative effect between two methods.The postoperative maximum flow rate [weighted mean difference（WMD） =4.70,95% CI（2.91,6.50）,P0.01]and postoperative urethral dilatation time CI（-7.31,-2.69）,P0.01]of holmium laser resection were higher than those of the transurethral cold knife urethrotomy,as well as the rate of re-operation [OR=0.19,95% CI（0.11,0.33）,P0.01]was lower than that of the cold knife urethrotomy.[Conclusion]Holmium laser resection is effective and superior to transurethral cold knife urethrotomy in the treatment of male patients with urethral stricture.There are less original studies and poor quality,so it is suggested to cautiously use it in clinic,and more high-quality,large sample randomized controlled trials are helpful for further discussion.

关 键 词：尿道狭窄 钬激光 冷刀 META分析 随机对照试验 

分 类 号：R181.3[医药卫生—流行病学]