经尿道前列腺切除术后并发膀胱颈挛缩危险因素的meta分析  

A meta-analysis of risk factors for concomitant bladder neck contracture after transurethral resection of the prostate

作　　者：施旭 魏武然[1] Shi Xu;Wei Wuran(Department of Urology,Institute of Urology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院泌尿外科,四川大学华西医院泌尿外科研究所,四川成都610041

出　　处：《中国男科学杂志》2024年第6期33-42,52,共11页Chinese Journal of Andrology

基　　金：四川省科学技术厅项目(2020YFSY0024,2023YFQ0004)。

摘　　要：目的系统评价经尿道前列腺切除术后发生膀胱颈挛缩(BNC)并发症的危险因素。方法检索PubMed、Web of Science、Cochrane Library、中国知网(CNKI)和万方数据库,搜集有关BNC发病危险因素的队列研究或随机对照试验。检索时限均为建库至2023年12月。由2名研究者独立筛选文献并提取数据,随后评价偏倚风险。Meta分析采用RevMan 5.4软件。结果前列腺大小[MD=-13.20,95%CI(-17.28,-9.13),P<0.01],术前尿路感染[OR=2.37,95%CI(1.23,4.57),P=0.01],术前诊断前列腺炎[OR=4.31,95%CI(2.61,7.13),P<0.01],手术时长[MD=8.32,95%CI(4.04,12.60),P<0.01],术前尿潴留及留置导尿[OR=0.81,95%CI(0.66,0.99),P=0.04],IP-SS[MD=-0.55,95%CI(-0.89,-0.22),P<0.01],以及术后病理诊断前列腺癌[OR=0.59,95%CI(0.39,0.90),P=0.01]是BNC发生的危险因素。结论术前识别BNC高危患者,术中针对危险因素及早采取预防措施,对于减少难治性BNC的发生具有重要的临床意义。Objective To systematically evaluate the risk factors of concomitant bladder neck contracture(BNC)after transurethral prostatectomy.Methods Cohort studies or randomized controlled trials on risk factors for concomitant BNC after transurethral prostatectomy were searched and collected from the database of PubMed,Web of Science,Cochrane Library,CNKI and WanFang database.The search interval was set form database establishment to December 2023.The related literatures and data were independently extracted by two researchers,and then the risk of bias was assessed.The meta-analysis was performed using RevMan 5.4 software.Results Prostate size[MD=13.20,95%CI(17.28,9.13),P<0.01],preoperative urinary tract infection(OR=2.37,95%CI(1.23,4.57),P=0.01),preoperative diagnosis of prostatitis[OR=4.31,95%CI(2.61,7.13),P<0.01],operation duration[MD=8.32,95%CI(4.04,12.60),P<0.01],preoperative urinary retention and indwelling catheter(OR=0.81,95%CI(0.66,0.99),P=0.04),IPSS[MD=0.55,95%CI(0.89,0.22),P<0.01],and postoperative pathological diagnosis of prostate cancer[OR=0.59,95%CI(0.39,0.90),P=0.01]were risk factors for BNC.Conclusion Preoperative identification of high-risk patients with BNC and early preventive measures against risk factors are of great clinical significance for reducing the occurrence of refractory BNC.

关 键 词：经尿道前列腺切除术 膀胱颈挛缩 危险因素 META分析 

分 类 号：R699.8[医药卫生—泌尿科学] R694[医药卫生—外科学]