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作 者:张若晨[1] 秦鑫[2] 刘志洪[1] 唐良友[1] 邹子君[1] 梁嘉宇 王玉杰[1] 唐勇泉 卢一平[1]
机构地区:[1]四川大学华西医院泌尿外科,成都610041 [2]成都市第一人民医院泌尿外科
出 处:《中华医学杂志》2016年第38期3094-3098,共5页National Medical Journal of China
基 金:四川省科学技术厅应用基础计划项目(2014JY0183);成都市科学技术局科技惠民项目(2014-HM01-00301-SF)
摘 要:目的对上尿路结石碎石术后运用Friend-Ⅰ型体外物理振动排石机(EPVL)辅助排石的疗效进行荟萃分析。方法检索Pubmed、Medline、Embase、Cochrane图书馆和中国知网光盘数据库从建刊至2016年3月期间的相关文献,收集所有比较上尿路结石碎石术后运用EPVL辅助排石患者与传统排石疗法患者之间疗效差异的随机对照实验(RCT)与半随机对照实验(Quasi-RCT),评价纳入研究质量,提取有效数据,采用Review Manager 5.3软件进行Meta分析。结果根据本研究设定的纳入与排除标准,最终纳入5篇RCT与Quasi-RCT。EPVL组首日排石率明显高于对照组(OR=4.95, 95% CI:3.35~7.32, P〈0.000 01);EPVL组1周后(OR=3.13, 95% CI:1.95~5.04,P〈0.000 01)及两周后(OR=4.50, 95% CI:2.02~10.00,P=0.000 2)结石排净率亦明显高于对照组。随访期间EPVL组未出现严重的不良事件。结论现有证据支持在临床中运用EPVL协助上尿路结石碎石术后的排石治疗。然而受限于本研究较小的样本量,能否在临床中常规运用EPVL协助排石治疗仍需要更多高质量、大样本的RCT研究来明确。ObjectiveTo determine the clinical effect of Friend-Ⅰ External Physical Vibration Lithecbole (EPVL) by Meta-analysis.MethodsPubmed, Embase, Medline, Cochrane Library, Chinese National Knowledge Infrastructure were searched for clinical trials comparing EPVL with the conventional treatment. The quality of included studies was assessed and Meta-analysis was conducted by Review Manager 5.3 software.ResultsFive randomized or Quasi-randomized controlled trials met the inclusion criteria. The first day stone expulsion rate of EPVL group was superior to the control group (OR=4.95, 95% CI: 3.35-7.32, P〈0.000 01). Both one-week (OR=3.13, 95% CI: 1.95-5.04, P〈0.000 01) and two-week stone free rate (OR=4.50, 95% CI: 2.02-10.00, P=0.000 2) were statistically higher in the EPVL group than that in the control group. No severe adverse event occurred during the follow-up.ConclusionsOur study suggested that EPVL could be the effective treatment for upper urinary tract residual stone. However, more high quality randomized controlled trials are needed to better affirm this.
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