FURL与PCNL治疗肾下极10～20mm结石疗效比较的Meta分析  

Flexible ureteroscopic lithotripsy versus percutaneous nephrolithotomy in treatment of lower pole renal calculi of 10～20mm:a meta-analysis

作　　者：杜广建[1] 阿里木.太来提 艾克帕尔.阿布拉江 吴冠伟[1] 阿不都赛买提.艾力 袁留亚 木拉提.马合木提 

机构地区：[1]新疆医科大学第二附属医院泌尿外科,乌鲁木齐830028 [2]兰州大学第一医院泌尿外科

出　　处：《浙江医学》2016年第5期348-351,共4页Zhejiang Medical Journal

摘　　要：目的系统评价经输尿管软镜取石术(FURL)与经皮肾镜取石术(PCNL.)治疗肾下极10~20mm结石的有效性和安全性。方法计算机检索The Cochrane Library、Pubmed、中国知网、维普及万方数据库,全面收集有关FURL和PCN L比较治疗肾下极结石的临床试验。由2位研究者独立进行文献筛选、资料提取和纳入研究的方法学质量评价后,采用RevMan 5.1软件进行Meta分析。结果共纳入5篇研究,均为非随机对照试验,共计379例患者。Meta分析结果显示:PCNL.的结石清除率(OR=3.62,95%CI:1.75~7.49,P<0.05)、手术时间(MD=-20.25,95%CI:-31.10^-9.41,P<0.05)明显优于FURL,而住院时间(MD=1,95%CI:0.63~1.37,P<0.05)方面则长于FURL,在手术所致发热、出血、输尿管结石等并发症方面两者均无统计学差异(均P>0.05)。结论现有证据显示,在结石清除率、手术时间方面,PCNL.优于FURL;而在住院时间方面,FURL则优于PCNL,两者在手术所致发热、出血、输血、输尿管结石等并发症方面并无明显差异。Objective To systematically review the efficacy and safety of flexible ureteroscope lithotripsy （FURL） and percutaneous nephrolithotomy（PCNL） in treatment of lower pole renal calculi of 10-20m. Methods The databases of Cochrane Library, PubMed, CNKI, VIP and WanFang Data were searched for clinical trials on comparison of FURL and PCNL in treatment of lower pole renal calculi of 10~20mm. Two reviewers independently screened studies according to exclusion and inclusion criteria, extracted data, and assessed the methodological quality. Then, meta-analysis was performed with RevMan 5.1 software. Results Five non-randomized controlled trials involving 379 patients were included. The results of meta-analysis showed that, PCNL was better than FURL in stone clearance （OR=3,62, 95% C1：1.75 ~7.49, P〈0.05） and operative time （MD=-20.25, 95% CI：-31. 10^-9.41, P〈0.05）, but FURL was better than PCNL in mean length of hospital stay （MD=1. 95% Cl：0.63-1.37, P〈0.05）. Conclusion Current evidence shows that PCNL increase the stone clearance rate and shorten operative time, FURL can shorten length of hospital stay. There were no statistically significant differences in incidence of postoperative complications including fever, hemorrhage, transfusion and distal ureteral calculi.

关 键 词：经输尿管软镜取石术(FURL) 经皮肾镜取石术(PCNL) 肾下极10~20mm结石 META分析 

分 类 号：R699.2[医药卫生—泌尿科学]