CAJ | 학술논문

目的应用Meta分析评价体外冲击波碎石和输尿管镜治疗输尿管上段结石的临床疗效和安全性。方法检索国内外有关体外冲击波碎石与输尿管镜治疗输尿管上段结石的完全随机对照试验，按Co-chrane 系统评价方法对文献进行质量评价和提取资料后，采用 RevMan 5.0统计软件进行 Meta 分析。结果共纳入5个随机对照试验，510例患者。结果显示，体外冲击波碎石组与输尿管镜组在随访期末结石完全清除率[OR＝1.03，95％CI（0.59，1.80），P＝0.92]及首次碎石成功率[OR＝0.42，95％CI（0.13，1.36）， P＝0.15]并没有显著差异，体外冲击波碎石可明显缩短患者的住院时间[ SMD＝-2.21，95％ CI （-2.82，-1.61），P＜0.00001]和手术时间[ SMD＝-1.37，95％CI（-2.34，-0.40），P＝0.005]；体外冲击波碎石手术相关并发症低于输尿管镜组[OR＝0.15，95％ CI（0.02，0.93），P＝0.04]。结论体外冲击波碎石可以明显缩短患者的住院时间和手术时间，降低患者手术相关并发症。由于纳入的文献较少，需要大样本的高质量的随机对照试验进一步证实。
목적응용Meta분석평개체외충격파쇄석화수뇨관경치료수뇨관상단결석적림상료효화안전성。방법검색국내외유관체외충격파쇄석여수뇨관경치료수뇨관상단결석적완전수궤대조시험，안Co-chrane 계통평개방법대문헌진행질량평개화제취자료후，채용 RevMan 5.0통계연건진행 Meta 분석。결과공납입5개수궤대조시험，510례환자。결과현시，체외충격파쇄석조여수뇨관경조재수방기말결석완전청제솔[OR＝1.03，95％CI（0.59，1.80），P＝0.92]급수차쇄석성공솔[OR＝0.42，95％CI（0.13，1.36）， P＝0.15]병몰유현저차이，체외충격파쇄석가명현축단환자적주원시간[ SMD＝-2.21，95％ CI （-2.82，-1.61），P＜0.00001]화수술시간[ SMD＝-1.37，95％CI（-2.34，-0.40），P＝0.005]；체외충격파쇄석수술상관병발증저우수뇨관경조[OR＝0.15，95％ CI（0.02，0.93），P＝0.04]。결론체외충격파쇄석가이명현축단환자적주원시간화수술시간，강저환자수술상관병발증。유우납입적문헌교소，수요대양본적고질량적수궤대조시험진일보증실。
Objective To compare the efficacy and safety of extracorporeal shock wave lithotripsy and ureteroscopy for the treatment of proximal ureteral calculi through a Meta analysis .Methods All randomized controlled trials ( RCTs ) of extracorporeal shock wave lithotripsy and ureteroscopy for the treatment of proximal ureteral calculi were collected .The quality of included RCTs was assessed .Relevant data were selected according to the standard of Cochrane systematic review .The statistical software RevMan 5.0 was used for Meta analysis . Results 5 randomized controlled trials with 510 cases were included .The results showed that between the two groups,there was no significant difference both in the stone-free rate at the end of follow-up[ OR=1.03,95% CI (0.59,1.80),P=0.92] and in the success rate of the first intervention [OR=0.42,95% CI(0.13,1.36),P=0.15 ] .Compared with the urteroscopy ,the Extracorporeal Shock Wave Lithotripsy had shorter hospital stay [ SMD=-2.21,95%CI(-2.82,-1.61),P<0.000 01],shorter procedure time [SMD=-1.37,95% CI( -2.34,-0.40),P=0.005] and lower complication [OR=0.15,95% CI(0.02,0.93),P=0.04].Conclusions The Extracorporeal Shock Wave Lithotripsy can have a shorter hospital stay ,procedure time and lower complication .More high-quality randomized controlled trials with large samples are required to verify the findings .