本文關鍵詞： 輸尿管結石 輸尿管支架管 隨機對照研究 Meta分析　出處：《臨床泌尿外科雜志》2016年07期 　論文類型：期刊論文

【摘要】：目的:評價非復雜性輸尿管鏡碎石術后常規(guī)留置輸尿管支架管的必要性。方法:計算機檢索中國生物醫(yī)學文獻數據庫(CBM)、中國學術期刊網絡出版總庫(CNKI)、維普資訊中文科技期刊數據庫(VIP)和萬方數據知識服務平臺(WANFANG datebase)、MEDLINE、EMbase、Cochrane圖書館,納入經輸尿管碎石術后留置輸尿管支架管的隨機對照研究(RCT)。主要評價兩組研究對象的手術時間、術后結石清除率、下尿路癥狀(排尿困難、血尿、尿頻)及再入院率、泌尿系感染率。采用RevMan5.2進行Meta分析。結果:共納入17個RCT,涉及經輸尿管鏡下碎石研究對象1 323例。Meta分析結果表明,非復雜性輸尿管鏡碎石術后:(1)兩組研究對象手術時間的差異有統(tǒng)計學意義(WMD=3.61,95%CI:1.45~5.76,P=0.001)。(2)兩組研究對象結石清除率的差異無統(tǒng)計學意義(RR=0.98,95%CI:0.96~1.00,P=0.09)。(3)兩組研究對象排尿困難發(fā)生率的差異有統(tǒng)計學意義(RR=2.21,95%CI:1.38~3.53,P=0.0009)。(4)兩組研究對象尿頻發(fā)生率的差異有統(tǒng)計學意義(RR=1.54,95%CI:1.06~2.23,P=0.002)。(5)兩組研究對象血尿發(fā)生率的差異有統(tǒng)計學意義(RR=1.85,95%CI:1.17~2.90,=0.008)。(6)兩組研究對象再入院率的差異有統(tǒng)計學意義(RR=0.42,95%CI:0.23~0.78,P=0.006)。(7)兩組研究對象泌尿系感染的差異無統(tǒng)計學意義(RR=0.32,95%CI:0.06~1.62,P=0.17)。結論:非復雜性輸尿管鏡下碎石術后沒有必要常規(guī)留置支架管,術后不留置支架管并不影響術后研究對象的結石清除率、泌尿系感染發(fā)生率等,但能夠縮短手術時間,減少術后下尿路癥狀發(fā)生率及再入院率。
[Abstract]:Objective: to evaluate the necessity of conventional indwelling ureteral stents after non-complex ureteroscopic lithotripsy. VIPs) and Wanfang data and knowledge service platform WANFANG datebase MEDLINEN EMbase Cochrane Library, A randomized controlled study was conducted to evaluate the operation time, postoperative stone clearance rate, lower urinary tract symptoms (dysuria, hematuria, frequency of ureter) and readmission rate of the two groups in a randomized controlled study of indwelling ureteral stents after ureteral lithotripsy. Urinary tract infection rate. RevMan5.2 was used for Meta analysis. Results: a total of 17 RCTs were included, involving 1 323 cases of ureteroscopic lithotripsy. The results of Meta analysis showed that: 1 323 cases were treated with ureteroscopic lithotripsy. The difference of operation time between the two groups was statistically significant. There was no significant difference in stone clearance rate between the two groups. There was no significant difference in the rate of stone removal between the two groups. The incidence of dysuria was significantly different between the two groups (RRN 0.98V 95: 0.961.00P0.09. 3) the incidence of dysuria in the two groups was significantly higher than that in the control group (P < 0.05), and there was no significant difference between the two groups in the incidence of dysuria. There is a significant difference in the incidence of urinary frequency between the two study groups. (RRN 1.5495 CI: 1.06U 2.23CU 0.002U. 5) there is a statistically significant difference in the incidence of hematuria between the two groups. There is a significant difference in the readmission rate between the two groups. There is a significant difference in readmission rate between the two groups (RR1.85 / 95CIW 1.172.90,0.0080.75). There is a statistically significant difference in readmission rate between the two groups. There was no significant difference in urinary tract infection between the two groups. Conclusion: there is no need for conventional stenting after noncomplicated ureteroscopic lithotripsy, and there is no significant difference between RRX 0.32 and 95% CI: 0.061.62P 0.170.Conclusion: there is no need for conventional stenting after noncomplicated ureteroscopic lithotripsy. The rate of stone removal and urinary tract infection were not affected by the non-indwelling stent, but it could shorten the operation time and reduce the incidence of lower urinary tract symptoms and readmission.
【作者單位】： 新疆醫(yī)科大學第二附屬醫(yī)院泌尿外科;
【基金】：國家自然科技基金資助項目(編號81460139)
【分類號】：R699.4

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