非复杂性输尿管结石输尿管镜碎石术后支架管留置必要性的Meta分析  

Necessity of ureteral stent after uncomplicated ureteroscopic lithotripsy for small ureteric stones:a Meta-analysis

作　　者：田河 刘亚东 闫本纯 宋静 邸彦橙 TIAN He LIU Ya-dong YAN Ben-chun SONG Jing DI Yan-cheng(Department of Urology, Hongqi Hospital of Mudanjiang Medical College,Mudanjiang 157011 ,China)

机构地区：[1]牡丹江医学院附属红旗医院泌尿外科,黑龙江牡丹江157011

出　　处：《现代泌尿外科杂志》2017年第10期773-778,802,共7页Journal of Modern Urology

摘　　要：目的应用Meta分析方法对非复杂性输尿管结石输尿管镜碎石术后支架管留置必要性进行分析。方法共收集文献13篇,纳入研究对象共计1 291例,其中术后留置支架管者670例,术后未留置支架管者621例。统计研究对象有手术时间、术后发热、术后输尿管狭窄、术后尿路感染、术后尿频尿急、术后尿痛、术后排尿困难、术后血尿、术后腰背部疼痛等。结果 Meta分析结果显示,未留置支架管在手术时间(MD:3.69,95%CI:2.57~4.81,P<0.01)、术后尿频尿急发生率(RR:2.11,95%CI:1.71~2.61,P<0.01)、术后尿痛发生率(RR:2.69,95%CI:2.03~3.57,P<0.01)、术后排尿困难发生率(RR:2.42,95%CI:1.94~3.01,P<0.01)、术后血尿发生率(RR:2.28,95%CI:1.80~2.90,P<0.01)、术后腰背部疼痛发生率(MD:1.53,95%CI:1.25~1.80,P<0.01)方面明显低于术后留置支架管研究组。结论 Meta分析可见对于非复杂性输尿管结石,未留置支架管会缩短手术时间、减轻术后尿路刺激症状等不适反应,所以非复杂性输尿管结石腔内碎石术后可考虑不予以留置支架管。Objective To assess the necessity of ureteral stent after ureteroscopic lithotripsy. Methods A total of 13 trials involving 1 291 participants were enrolled,including 670 in the stent group and 621 in the non-stent group. The operation time, postoperative fever, urinary tract infection, ureteral stricture, dysuria, urinary irritation symptoms, hematuria and lumbar back pain were analyzed. Results Compared with the stent group,the non-stent group showed shorter operation time （MD： 3.69,95 % CI ： 2.57 - 4.81, P〈 0.01 ）, lower incidence of urinary frequency and urgency （ RR： 2.11,95 % CI ： 1.71 - 2.61, P 〈 0.01）,urodynia （RR：2.69,95%Cl：2.03-3.57,P〈0.01）,dysuresia （RR：2.42,95% CI：1. 94- 3.01,P〈0.01）,hematuresis （RR：2.28,95%CI：1.80-2.90,P〈0.01）,and lumbar back pain （MD：1. 53,95% CI：1. 25-1.80,P〈0.01）. Conclusion This Meta-analysis reveals that after uncomplicated ureteroscopic lithotripsy for small ureteric stones, the non-stent group shows shorter operation time,fewer urinary irritation symptoms and higher quality of life. Therefore, we suggest that ureteral stent shouldn＇t be placed if the stone is not complicated.

关 键 词：非复杂性输尿管结石 输尿管镜 支架管 META分析 

分 类 号：R692.4[医药卫生—泌尿科学]