超选择性肾动脉栓塞治疗医源性肾出血临床疗效的Meta分析  

The clinical efficacy of superselective renal artery embolization in the treatment of iatrogenic renal hemorrhage:a meta-analysis

作　　者：麦美芳[1] 杨小月[2] 欧春霞[1] 朱伟平[1] 朱晔[1] 罗雯馨 Mai Meifang;Yang Xiaoyue;Ou Chunxia;Zhu Weiping;Zhu Ye;Luo Wenxin(Department of Nephrology,the Fifth Affiliated Hospital of Sun Yat-sen University,Guangdong Zhuhai 519000,China;Department of Nursing,the Fifth Affiliated Hospital of Sun Yat-sen University,Guangdong Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院肾内科,广东珠海519000 [2]中山大学附属第五医院护理部,广东珠海519000

出　　处：《中华介入放射学电子杂志》2021年第3期319-325,共7页Chinese Journal of Interventional Radiology：electronic edition

摘　　要：目的评价超选择性肾动脉栓塞治疗医源性肾出血的有效性和安全性。方法检索多个中英文数据库截至2021年4月9日的研究。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R软件3.6.0和Stata 12.0进行Meta分析。结果最终13项研究符合纳入标准,包含293名患者。经皮肾镜取石术后是造成医源性肾出血的主要原因,比例为53.04%(95%CI:36.59,69.49),止血完全率大于99%(95%CI:98,100),单次栓塞止血完全率为96%(95%CI:91,99),二次栓塞止血机率为8%(95%CI:5,12),不良事件即栓塞后综合征发生率为21%(95%CI:12,34)。结论超选择性肾动脉栓塞术是治疗医源性肾出血的有效方法,具有成功率高、安全有效且并发症少,在治疗医源性肾出血具有较高的临床应用价值。Objective To evaluate the efficacy and safety of superselective renal arterial embolization in the treatment of iatrogenic renal hemorrhage.Methods Multiple Chinese and English databases were electronically searched as of April 9,2021.Two reviewers independently screened the literature,extracted the data and assessed the risk of bias of the included studies,then,meta-analysis was performed by using R version 3.6.0 software and Stata 12.0 software.Results The total of 13 studies met the inclusion criteria and included 293 patients.Percutaneous nephrolithotomy was the main cause of iatrogenic renal hemorrhage,which proportion was 53.04%(95%CI:36.59,69.49),and the complete hemostasis rate was greater than 99%(95%CI:98,100),the single-embolization hemostasis rate was 96%(95%CI:91,99),the proportion of secondary-embolization hemostasis was 8%(95%CI:5,12),and the incidence of adverse events,post-embolism syndrome,was 21%(95%CI:12,34).Conclusions Superselective renal artery embolization is an effective method for the treatment of iatrogenic renal hemorrhage with high success rate,safety and effectiveness,and fewer adverse reactions,which is worthy of wide application and promotion.

关 键 词：META分析 超选择性肾动脉栓塞 医源性肾出血 栓塞后综合征 

分 类 号：R692[医药卫生—泌尿科学]