标准通道和微通道PCNL在不同肾盂压力下治疗感染性肾结石效果的Meta分析  

Meta-analysis of effects of standard channel and micro-channel PCNL in the treatment of infectious renal calculi under different renal pelvic pressure

作　　者：操作亮[1] 刘双林[1] 袁劲东[1] 章传华[1] 黄遂斌[1] 吴维[1] 刘懿鹏 

机构地区：[1]武汉市第一医院泌尿外科,湖北武汉430022

出　　处：《东南大学学报（医学版）》2017年第5期735-742,共8页Journal of Southeast University(Medical Science Edition)

基　　金：武汉市卫计委支持项目(WX11D01)

摘　　要：目的:对比分析标准通道(F24~F34)和微通道(F16~F18)经皮肾镜(PCNL)治疗感染性肾结石的效果。方法:在Pub Med、Embase、CNKI、万方等医学数据库,检索PCNL治疗肾结石的临床随机对照试验(RCT),由两位工作者独立提取文献数据,利用Stata 14.0软件对纳入文献进行Meta分析,探索标准通道和微通道的治疗效果。结果:本研究共纳入11篇随机对照试验文献,包括2 152例肾结石病人,Meta分析结果显示低肾盂压力下微通道PCNL(MPCNL)并发症RR=0.63(95%CI:0.63~1.06),术中出血量RR=-0.94(95%CI:-1.29^-0.59);PCNL并发症RR=0.39(95%CI:0.21~0.71),术中出血量RR=-1.48(95%CI:-1.87^-1.08)。结论:低肾盂压力下可以减少术后并发症及术中出血量;但MPCNL的治疗效果(结石清除率及术后并发症发生率)与PCNL比较没有明显的优势。Objective： To compare the efficacy of percutaneous nephrolithotomy（PCNL） for the treatment of nephrolithiasis with standard channels（F24-F34） and micro-channels（F16-F18）.Methods： Randomized controlled trials（RCTs） of PCNL nephrolithiasis were retrieved from Pub Med,Embase,CNKI,Wanfang and other medical databases.Literatures were independently extracted by two workers.Stata 14.0 software was used for this Meta-analysis.Explore the efficacy of standard channel and micro-channel PCNL（MPCNL） treatment.Results： In this study,11 randomized controlled trials involving 2 152 patients with nephrolithiasis were analyzed.The Metaanalysis showed that the complications of hypo renal pelvic pressure RR = 0.63（95% CI： 0.63 to 1.06） and blood loos RR =-0.94（95% CI：-1.29 to-0.59） for MPCNL,complications RR = 0.39（95% CI： 0.21 to 0.71）and blood loss RR =-1.48（95% CI：-1.87 to-1.08） for PCNL.Conclusion： MPCNL is less effective than PCNL in terms of stone clearance rate and postoperative complication rate,but it can reduce postoperative complications and intraoperative blood loss with hypo renal pelvic pressure.

关 键 词：标准通道 微通道 经皮肾镜 META分析 

分 类 号：R692.4[医药卫生—泌尿科学] R616.5[医药卫生—外科学]