前列腺动脉栓塞术与经尿道前列腺电切术治疗良性前列腺增生的系统评价与Meta分析  

Systematic evaluation and Meta analysis of prostatic arterial embolization versus transurethral resection of the prostate in treating benign prostatic hyperplasia

作　　者：李静静 徐新建 黄祥忠[2] LI Jingjing;XU Xinjian;HUANG Xiangzhong(Department of Radiology,Affiliated Taizhou Hospital of Wenzhou Medical University,Taizhou,Zhejiang 317000,China;Department of Interventional Radiology,Jiangyin Municipal People′s Hospital,Jiangyin,Jiangsu 214400,China)

机构地区：[1]温州医科大学附属台州医院放射科,317000 [2]江苏省江阴市人民医院介入放射科,214400

出　　处：《重庆医学》2020年第5期802-808,823,共8页Chongqing medicine

摘　　要：目的采用Meta分析比较前列腺动脉栓塞术(PAE)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的有效性及安全性。方法检索Pubmed、Web of science、Embase、Cochrane library、Clinical Trial.gov、知网、万方、维普数据库,收集截至2019年2月关于PAE与TURP的随机对照研究(RCT)。采用Rev Man5.3软件进行Meta分析。结果纳入4项RCT研究,共276例BPH患者。TURP与PAE术后国际前列腺症状评分改善状况(MD=2.11;95%CI:-0.18~4.39;P=0.07)、生活质量评分改善状况(MD=0.28;95%CI:-0.22~0.78;P=0.28)、术后排泄后残余尿量改善状况(MD=11.00;95%CI:-16.47~38.48;P=0.43)、并发症发生率(RR=0.96;95%CI:0.36~2.53;P=0.93)及性功能障碍发生率(RR=0.33;95%CI:0.08~1.28;P=0.11)差异无统计学意义,而TURP术后前列腺体积缩小状况(MD=8.29;95%CI:5.21~11.36;P<0.01)及术后最大尿流率改善状况(MD=5.64;95%CI:1.30~9.98;P=0.01)均优于PAE。结论TURP仍是治疗BPH的金标准,但对存在手术禁忌证的BPH患者,PAE可能是一项有价值的替代治疗手段,但目前仍需更多大样本、长期随访的RCT研究来证实PAE可否作为BPH常规治疗方法。Objective To compare the efficacy and safety of prostatic arterial embolization(PAE)and transurethral resection of the prostate(TURP)in treating benign prostatic hyperplasia(BPH)by using the Meta-analysis.Methods The PubMed,Web of science,Embase,Cochrane Library,Clinical Trial.gov,CNKI,Wanfang and VIP databases were retrieved for collecting the randomized controlled trials(RCTs)on PAE and TURP until February 2019.The RevMan5.3 software was adopted for conducting the Meta-analysis.Results Four RCTs were included,involving 276 patients with BPH.There were no statistically significant differences in postoperative improvement of IPSS score(MD=2.11;95%CI:-0.18-4.39;P=0.07),improvement of QOL score(MD=0.28;95%CI:-0.22-0.78;P=0.28),residual urine volume after postoperative excretion(MD=11.00;95%CI:-16.47-38.48;P=0.43),occurrence rate of complications(RR=0.96;95%CI:0.36-2.53;P=0.93)and occurrence rate of sexual dysfunction(RR=0.33;95%CI:0.08-1.28;P=0.11)between the PAE group and TURP group;however,reduction of postoperative prostate volume(PV)(MD=8.29;95%CI:5.21-11.36;P<0.01)and improvement of postoperative Qmax(MD=5.64;95%CI,1.30-9.98;P=0.01)in TURP were better than those in PAE.Conclusion PAE is is still the golden standard for treating BPH;however,PAE may be a valuable alternative to TURP in BPH patients with surgical contraindication.At present,more RCT including longer follow-up periods and larger sample should be needed to verify whether PAE can serve as a routine treatment.

关 键 词：良性前列腺增生 前列腺动脉栓塞术 经尿道前列腺电切术 META分析 

分 类 号：R697.33[医药卫生—泌尿科学]