中国人群泌尿系结石复发率的Meta分析  

A Meta-analysis of the recurrence rate of urinary calculi in Chinese population

作　　者：靳通通 罗玉红 安景景 周逢海 JIN Tongtong;LUO Yuhong;AN Jingjing;ZHOU Fenghai(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;Department of Urology,Gansu Provincial People's Hospital,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]甘肃省人民医院泌尿外科,甘肃兰州730000

出　　处：《现代泌尿外科杂志》2021年第12期1030-1035,1065,共7页Journal of Modern Urology

摘　　要：目的探讨中国人群泌尿系结石的复发率,为预防和干预结石复发提供理论依据。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CNKI、VIP数据库、CBM数据库及万方数据库,搜集自建库至2020年12月的研究文献。采用R 4.1.0软件进行Meta分析。结果共纳入25个研究,包括2628例患者,Meta分析显示中国人群泌尿系结石复发率为0.06(95%CI:0.03~0.10,P<0.01)。其中,不同样本量亚组分析显示:样本量≥50例和<50例复发率分别为0.06(95%CI:0.03~0.09,P<0.01)和0.12(95%CI:0.01~0.30,P<0.01);不同部位亚组分析显示:肾结石、输尿管结石、上段输尿管结石和膀胱结石的复发率分别为0.12(95%CI:0.07~0.18,P<0.01)、0.05(95%CI:0.01~0.09,P<0.01)、0.04(95%CI:0~0.10,P<0.01)和0.01(95%CI:0~0.07,P<0.01);不同手术方式亚组分析显示:经皮肾取石术、后腹腔镜输尿管切开取石术、输尿管镜取石术、输尿管镜钬激光碎石术、经尿道膀胱气压弹道碎石术的复发率分别为0.11(95%CI:0.05~0.18,P<0.01)、0.01(95%CI:0~0.05,P<0.01)、0.09(95%CI:0.04~0.15,P<0.01)、0.09(95%CI:0.06~0.14,P=0.27)和0.02(95%CI:0~0.12,P<0.01);不同随访时间亚组分析显示:>6个月与≥3个月且≤6个月的复发率分别为0.09(95%CI:0.04~0.16,P<0.01)和0.06(95%CI:0.01~0.15,P<0.01);不同类型肾结石亚组分析显示:特殊类型肾结石和普通肾结石复发率分别为0.13(95%CI:0.06~0.23,P<0.01)和0.12(95%CI:0.06~0.20,P<0.01)。结论当前证据表明泌尿系结石的复发率较高,需引起一定的重视并采取相应的干预措施,以改善泌尿系结石患者的生活质量。Objective To investigate the recurrence rate of urinary calculi in Chinese population so as to provide a theoretical basis for the prevention and intervention.Methods Relevant studies were searched in PubMed,Embase,Cochrane Library,Web of Science,CNKI,VIP database,CBM database and Wanfang Database from inception to Dec.2020,and the data were analyzed with R 4.1.0 software.Results A total of 25 studies were included,involving 2628 patients.The results of Meta-analysis showed that the recurrence rate of urinary calculi in Chinese population was 0.06(95%CI:0.03-0.10,P<0.01).The recurrence rates of urinary calculi in the≥50 patients subgroup and<50 patients subgroup were 0.06(95%CI:0.03-0.09,P<0.01)and 0.12(95%CI:0.01-0.30,P<0.01),respectively.The recurrence rates of renal calculi,ureteral calculi,upper ureteral calculi and bladder calculi were 0.12(95%CI:0.07-0.18,P<0.01),0.05(95%CI:0.01-0.09,P<0.01),0.04(95%CI:0-0.10,P<0.01)and 0.01(95%CI:0-0.07,P<0.01),respectively.The recurrence rates after percutaneous nephrolithotomy,retroperitoneal laparoscopic ureterolithotomy,ureteroscopic lithotomy,ureteroscopic holmium laser lithotripsy,and transurethral pneumatic lithotripsy were 0.11(95%CI:0.05-0.18,P<0.01),0.01(95%CI:0-0.05,P<0.01),0.09(95%CI:0.04-0.15,P<0.01),0.09(95%CI:0.06-0.14,P=0.27)and 0.02(95%CI:0-0.12,P<0.01),respectively.The recurrence rates in the follow-up>6 months and 6 months≤follow-up≥3 months groups were 0.09(95%CI:0.04-0.16,P<0.01)and 0.06(95%CI:0.01-0.15,P<0.01),respectively.The recurrence rates of special types of renal calculi and common renal calculi were 0.13(95%CI:0.06-0.23,P<0.01)and 0.12(95%CI:0.06-0.20,P<0.01),respectively.Conclusion The recurrence rate of urinary calculi is high.Due attention and appropriate intervention measures are needed to improve patients quality of life.

关 键 词：泌尿系结石 复发率 中国人群 META分析 临床研究 

分 类 号：R691.4[医药卫生—泌尿科学]