中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
43期
7047-7052
,共6页
艾尼瓦尔·艾尔肯%王令令%钟山%周佗%单斗联
艾尼瓦爾·艾爾肯%王令令%鐘山%週佗%單鬥聯
애니와이·애이긍%왕령령%종산%주타%단두련
生物材料%材料相容性%输尿管下段结石%钬激光碎石%气压弹道碎石%Meta分析
生物材料%材料相容性%輸尿管下段結石%鈥激光碎石%氣壓彈道碎石%Meta分析
생물재료%재료상용성%수뇨관하단결석%화격광쇄석%기압탄도쇄석%Meta분석
背景：气压弹道碎石与钬激光碎石治疗输尿管下段结石疗效及并发症各有优劣，但均为目前较好的方法。<br> 目的：应用Meta分析评价钬激光碎石和气压弹道碎石治疗输尿管下段结石的临床疗效和安全性。<br> 方法：应用计算机搜索1999年3月至2013年11月中国生物医学文献数据库、PubMed、Cochrane图书馆、Springerlink (医学全文)、Medline 和 Embase 等电子数据库，并手工式检索相关杂志，搜索输尿管镜钬激光与气压弹道治疗输尿管下段结石疗效比较的临床研究，利用RevMan5.1.5软件行Meta分析，比较手术时间、结石清除率、输尿管穿孔率、结石上移和双J管保留率等指标。<br> 结果与结论：纳入4个前瞻性研究，共272例患者，其中钬激光组140例，气压弹道组132例。钬激光组平均手术时间[WMD=-16.38，95%CI (-20.29，-12.47)，P<0.00001]、结石上移率[OR=0.25，95%CI(0.10，0.63)，P=0.003]少于气压弹道组，双J管保留率[OR=0.44，95%CI(0.25，0.78)，P=0.004]高于气压弹道组。两组首次结石排净率、血尿发生率、输尿管穿孔率比较差异无显著性意义。结果表明与气压弹道碎石比较，钬激光碎石可以明显缩短手术时间，降低结石移位。由于缺乏关于课题前瞻性研究及样本量相对较少的原因，尚需更多及严密设计大样本随机对照研究，文章结论仅具有参考价值。
揹景：氣壓彈道碎石與鈥激光碎石治療輸尿管下段結石療效及併髮癥各有優劣，但均為目前較好的方法。<br> 目的：應用Meta分析評價鈥激光碎石和氣壓彈道碎石治療輸尿管下段結石的臨床療效和安全性。<br> 方法：應用計算機搜索1999年3月至2013年11月中國生物醫學文獻數據庫、PubMed、Cochrane圖書館、Springerlink (醫學全文)、Medline 和 Embase 等電子數據庫，併手工式檢索相關雜誌，搜索輸尿管鏡鈥激光與氣壓彈道治療輸尿管下段結石療效比較的臨床研究，利用RevMan5.1.5軟件行Meta分析，比較手術時間、結石清除率、輸尿管穿孔率、結石上移和雙J管保留率等指標。<br> 結果與結論：納入4箇前瞻性研究，共272例患者，其中鈥激光組140例，氣壓彈道組132例。鈥激光組平均手術時間[WMD=-16.38，95%CI (-20.29，-12.47)，P<0.00001]、結石上移率[OR=0.25，95%CI(0.10，0.63)，P=0.003]少于氣壓彈道組，雙J管保留率[OR=0.44，95%CI(0.25，0.78)，P=0.004]高于氣壓彈道組。兩組首次結石排淨率、血尿髮生率、輸尿管穿孔率比較差異無顯著性意義。結果錶明與氣壓彈道碎石比較，鈥激光碎石可以明顯縮短手術時間，降低結石移位。由于缺乏關于課題前瞻性研究及樣本量相對較少的原因，尚需更多及嚴密設計大樣本隨機對照研究，文章結論僅具有參攷價值。
배경：기압탄도쇄석여화격광쇄석치료수뇨관하단결석료효급병발증각유우렬，단균위목전교호적방법。<br> 목적：응용Meta분석평개화격광쇄석화기압탄도쇄석치료수뇨관하단결석적림상료효화안전성。<br> 방법：응용계산궤수색1999년3월지2013년11월중국생물의학문헌수거고、PubMed、Cochrane도서관、Springerlink (의학전문)、Medline 화 Embase 등전자수거고，병수공식검색상관잡지，수색수뇨관경화격광여기압탄도치료수뇨관하단결석료효비교적림상연구，이용RevMan5.1.5연건행Meta분석，비교수술시간、결석청제솔、수뇨관천공솔、결석상이화쌍J관보류솔등지표。<br> 결과여결론：납입4개전첨성연구，공272례환자，기중화격광조140례，기압탄도조132례。화격광조평균수술시간[WMD=-16.38，95%CI (-20.29，-12.47)，P<0.00001]、결석상이솔[OR=0.25，95%CI(0.10，0.63)，P=0.003]소우기압탄도조，쌍J관보류솔[OR=0.44，95%CI(0.25，0.78)，P=0.004]고우기압탄도조。량조수차결석배정솔、혈뇨발생솔、수뇨관천공솔비교차이무현저성의의。결과표명여기압탄도쇄석비교，화격광쇄석가이명현축단수술시간，강저결석이위。유우결핍관우과제전첨성연구급양본량상대교소적원인，상수경다급엄밀설계대양본수궤대조연구，문장결론부구유삼고개치。
BACKGROUND:Pneumatic lithotripsy and holmium laser lithotripsy for distal ureteral calculi have their own advantages and disadvantages in efficacy and complications, but both of them are currently better treatments. <br> OBJECTIVE:To compare the efficacy and safety of holmium laser lithotripsy and pneumatic lithotripsy for the treatment of distal ureteral calculi through a meta analysis. <br> METHODS:A online search of China Biological Medicine disk, PubMed, Cochrane Library, Springerlink, Medline, and Embase databases was performed from March 1999 to December 2013. A manual retrieval of relevant journals was also done for clinical trials about holmium laser lithotripsy and pneumatic lithotripsy for treatment of distal ureteral calculi. RevMan 5.1.5 software (Cachrane Library) was used for meta analysis. The fol owing indexes were used to compare the results:mean operative time, early stone free rate, stone migration rate, ureteral perforation rate, postoperative hematuria rate and retaining double-J catheter rate. <br> RESULTS AND CONCLUSION:Four prospective studies (a total of 275 patients) were enrol ed, and there were 140 cases in the group of holmium laser lithotripsy and 133 cases in the pneumatic Lithotripsy group. Holmium laser lithotripsy conveyed significant benefits compared with pneumatic lithotripsy in mean operative time [WMD=-16.38, 95%CI (-20.29,-12.47), P<0.000 01], stone migration incidence [OR=0.25, 95%CI (0.10, 0.63), P=0.003], retaining double-J catheter rate [OR=0.44, 95%CI (0.25, 0.78), P=0.004], while early stone free rate, postoperative hematuria rate and ureteral perforation rate had no significant changes between the two groups. Compared with pneumatic lithotripsy, holmium laser lithotripsy can shorten mean operative time and reduce the stone migration rate. Because of the lack of prospective studies and smal sample size, large-sized randomized control ed studies are urgently needed to provide evidence.
