系统评价与荟萃分析HIFU联合TURP在前列腺癌治疗中的有效性及安全性  

Comparison the efficacy and safety of HIFU combined TURP in the treatment prostate cancer:a systemic review and meta-analysis

作　　者：潘阳 陈华林 熊超玉 陈函 朱云霄 杨紫依 陈刚[1] PAN Yang;CHEN Hualin;XIONG Chaoyu;CHEN Han;ZHU Yunxiao;YANG Ziyi;CHEN Gang(Department of Urology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 40000,China)

机构地区：[1]重庆医科大学附属第一医院泌尿外科,重庆400016

出　　处：《现代医药卫生》2019年第9期1284-1287,1290,共5页Journal of Modern Medicine & Health

基　　金：重庆市科学技术委员会项目(cstc2015shmszx120067)

摘　　要：目的基于现存可利用的高强度聚焦超声(HIFU)与经尿道前列腺电切术(TURP)研究报道,系统性评估HIFU联合TURP在前列腺癌治疗中的有效性与安全性。方法通过检索PubMed、Embase、Cochrane library、中国知网数据库,系统性地收集所有比较HIFU联合TURP与单独使用HIFU治疗前列腺癌的临床试验,检索时间均从建库至2019年1月。根据纳入及排除标准,2名系统评价员独立地进行文献筛选及数据提取,应用RevMan 5.3.0软件进行荟萃分析。结果最终纳入5个临床研究,共包含886例患者,其中449例仅接受HIFU治疗(HIFU组),437例接受HIFU联合TURP治疗(HIFU联合TURP组)。HIFU联合TURP组术后3、6个月的国际前列腺症状评分(IPSS)均小于HIFU组,差异均有统计学意义(P<0.05)。HIFU联合TURP组术后膀胱造瘘管留置时间少于HIFU组,术后泌尿生殖系统感染及术后Ⅱ度尿失禁发生率均小于HIFU组,差异均有统计学意义(P<0.05)。2组在术后Ⅰ度尿失禁、术后膀胱颈挛缩及术后直肠尿道瘘方面比较差异均无统计学意义(P>0.05)。结论利用HIFU联合TURP治疗前列腺癌患者,能够有效改善排尿困难症状,提高生活质量,降低术后并发症发生率,建议推广应用。Objective To evaluate the efficacy and safety of high intensity focused ultrasound (HIFU) combined with transurethral resection of the prostate (TURP) in the treatment of prostate cancer based on existing available HIFU and TURP. Methods All clinical trials comparing HIFU with TURP and HIFU alone for prostate cancer were systematically collected by searching PubMed,Embase,Cochrane library,and China Knowledge Network database.The retrieval time was from building to January 2019.According to the inclusion and exclusion criteria,two systematic reviewers independently performed literature screening and data extraction,and meta-analysis was performed using RevMan 5.3.0 software. Results The meta-analysis was finally included in 5 clinical studies,including 886 patients,of whom 449 received HIFU only (HIFU group) and 437 received HIFU plus TURP (HIFU combined with TURP group).The efficacy index (IPSS) of HIFU combined with TURP group at 3 and 6 months after operation was lower than that of HIFU group,and the differences were statistically significant ( P <0.05).The indwelling time of bladder fistula was lower in HIFU combined with TURP group than that in HIFU group,the incidence of postoperative urogenital infection and postoperative Ⅱ incontinence were lower than those in HIFU group ( P <0.05).There were no significant differences between the two groups in postoperative Ⅰ degree urinary incontinence,postoperative bladder neck contracture and postoperative rectal urethral fistula ( P >0.05). Conclusion The use of HIFU combined with TURP in the treatment of patients with prostate cancer can effectively improve the symptoms of dysuria,improve the quality of life,and reduce the incidence of postoperative complications.

关 键 词：高强度聚焦超声 经尿道前列腺电切术 前列腺癌 meta分析 

分 类 号：R737.25[医药卫生—肿瘤]