【摘要】：目的:系統(tǒng)評(píng)價(jià)完全無(wú)管化經(jīng)皮腎鏡碎石術(shù)與標(biāo)準(zhǔn)經(jīng)皮腎鏡碎石術(shù)治療上尿路結(jié)石的療效方法:通過計(jì)算機(jī)檢索國(guó)內(nèi)外數(shù)據(jù)庫(kù),含Pubmed、The Cochrane Library、Embase、中國(guó)生物醫(yī)學(xué)數(shù)據(jù)庫(kù)、中國(guó)知網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù),搜索符合要求的隨機(jī)對(duì)照試驗(yàn)和臨床對(duì)照試驗(yàn),篩選文獻(xiàn)后進(jìn)行相關(guān)數(shù)據(jù)提取,最后采用Review Manager 5.3軟件對(duì)數(shù)據(jù)進(jìn)行Meta分析。結(jié)果:最后11篇文獻(xiàn)納入了研究,其中試驗(yàn)組有439例研究對(duì)象,對(duì)照組有485例研究對(duì)象,Meta分析示:(1)手術(shù)總并發(fā)癥:兩組之間差異據(jù)有統(tǒng)計(jì)學(xué)意義,[OR:0.44,95%CI:0.26~0.74,P=0.002](2)術(shù)后發(fā)熱:兩組之間差異沒有統(tǒng)計(jì)學(xué)意義,[OR:0.76,95%CI:0.38~1.50,P=0.42](3)血尿:兩組之間差異沒有統(tǒng)計(jì)學(xué)意義,[OR:0.60,95%CI:0.14~2.54,P=0.49](4)術(shù)后腎周積液:兩組間差異沒有統(tǒng)計(jì)學(xué)意義,[OR:0.41,95%CI:0.13~1.29,P=0.13](5)術(shù)后輔助排石:兩組間差異沒有統(tǒng)計(jì)學(xué)意義,[OR:0.92,95%CI:0.42~2.01,P=0.83](6)術(shù)后輸血:兩組間差異沒有統(tǒng)計(jì)學(xué)意義,[OR:0.69,95%CI:0.35~1.37,P=0.29](7)手術(shù)時(shí)間:兩組間差異沒有統(tǒng)計(jì)學(xué)意義,[WMD:-1.71,95%CI:-3.58~0.16,P=0.07](8)住院時(shí)間:兩組間差異有統(tǒng)計(jì)學(xué)意義,[WMD:-2.35,95%CI:-3.20~-1.49,P0.00001](9)術(shù)后恢復(fù)到正�；顒�(dòng)時(shí)間:兩組間差異沒有統(tǒng)計(jì)學(xué)意義,[WMD:-6.88,95%CI:-14.27~0.50,P=0.07](10)術(shù)后肌酐和血紅蛋白下降情況:兩組間差異沒有統(tǒng)計(jì)學(xué)意義,[WMD:-0.01,95%CI:-0.03~0.01,P=0.48]和[WMD:-0.10,95%CI:-0.22~0.01,P=0.07](11)術(shù)后鎮(zhèn)痛藥的使用情況:兩組間差異有統(tǒng)計(jì)學(xué)意義,[WMD:-6.81,95%CI:-8.40~-5.22,P0.00001]。結(jié)論:完全無(wú)管化經(jīng)皮腎鏡取石術(shù)與標(biāo)準(zhǔn)經(jīng)皮腎鏡取石術(shù)治療上尿路結(jié)石方面對(duì)比,在住院時(shí)間、術(shù)后鎮(zhèn)痛藥使用量、術(shù)后總的并發(fā)癥方面具有優(yōu)勢(shì),差異具有統(tǒng)計(jì)學(xué)意義;在手術(shù)時(shí)間、術(shù)后恢復(fù)到正�；顒�(dòng)時(shí)間、術(shù)后輸血、術(shù)后發(fā)熱、術(shù)后腎周積液、術(shù)后輔助排石、術(shù)后肌酐和血紅蛋白下降、血尿方面差異無(wú)統(tǒng)計(jì)學(xué)意義,掌握好完全無(wú)管化經(jīng)皮腎鏡取石術(shù)治療適應(yīng)癥和嚴(yán)格篩選病人的情況下,值得謹(jǐn)慎推廣
[Abstract]:Objective: to systematically evaluate the efficacy of completely non-tubular percutaneous nephrolithotomy and standard transcatheter lithoclast in the treatment of upper urinary calculi. The database at home and abroad, including Pubmed,The Cochrane Library,Embase, Chinese Biomedical Database, was searched by computer. China knowledge network, Wanfang database, search for randomized controlled trials and clinical controlled trials that meet the requirements, screen the literature and extract the relevant data. Finally, Review Manager 5.3 software is used for Meta analysis of the data. Results: the last 11 articles were included in the study, including 439 cases in the experimental group and 485 cases in the control group. Meta analysis showed that: (1) the total complications of the operation: the difference between the two groups was statistically significant. [OR:0.44,95%CI:0.26~0.74,P=0.002] (2) postoperative fever: there was no significant difference between the two groups. [OR:0.76,95%CI:0.38~1.50,] P 鈮，

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