CAJ | 학술논문

目的：系统评价逆行输尿管软镜激光碎石术治疗肾结石具有的优势。方法：通过检索Pubmed、Co-chrane library、CBMdisc、EMBASE、CNKI等数据库有关逆行输尿管软镜激光碎石术与经皮肾镜取石术(Percuta-neous nephrolithotomy,PCNL)治疗肾结石的对照试验文献，并追查纳入文献的参考文献，对符合纳入标准的研究使用统计软件RevMan5.2完成Meta分析。结果：经筛选，最后纳入8篇文献，共590例，进行Meta分析，与肾镜组比较，软镜组：（1）结石清除率(RR 0.95,95%CI 0.88至1.02,P=0.15)和术后发热率(RR 0.95,95%CI 0.54至1.67,P=0.85)无统计学意义；（2）平均手术时间延长19.11分钟(WMD19.11,95%CI 7.83至30.39,P＜0.05）；（3）平均住院时间减少2.1天(WMD-2.1,95%CI-3.08至-1.11,P＜0.05)；（4）出血发生率显著降低(RR 0.20,95%CI 0.06至0.68,P=0.01).结论：与PCNL比较，逆行输尿管软镜激光碎石术具有住院时间短，出血并发症低的优势。
목적：계통평개역행수뇨관연경격광쇄석술치료신결석구유적우세。방법：통과검색Pubmed、Co-chrane library、CBMdisc、EMBASE、CNKI등수거고유관역행수뇨관연경격광쇄석술여경피신경취석술(Percuta-neous nephrolithotomy,PCNL)치료신결석적대조시험문헌，병추사납입문헌적삼고문헌，대부합납입표준적연구사용통계연건RevMan5.2완성Meta분석。결과：경사선，최후납입8편문헌，공590례，진행Meta분석，여신경조비교，연경조：（1）결석청제솔(RR 0.95,95%CI 0.88지1.02,P=0.15)화술후발열솔(RR 0.95,95%CI 0.54지1.67,P=0.85)무통계학의의；（2）평균수술시간연장19.11분종(WMD19.11,95%CI 7.83지30.39,P＜0.05）；（3）평균주원시간감소2.1천(WMD-2.1,95%CI-3.08지-1.11,P＜0.05)；（4）출혈발생솔현저강저(RR 0.20,95%CI 0.06지0.68,P=0.01).결론：여PCNL비교，역행수뇨관연경격광쇄석술구유주원시간단，출혈병발증저적우세。
Objective To systematically review the advantages of the retrograde intrarenal surgery in the treatment of renal stones.Methods We searched Pubmed Cochrane library,CBMdisc,Embase,wanfang,VIP and other databases about the retrograde intrarenal surgery and percutaneous nephrolithotomy in the treatment of renal stones. All clinical trials were retrieved and their included references were investigated. The eligible studies were included and analyzed using RevMan 5.2. Results Eight literatures were retrieved, including 590 patients. The Meta-analysis results showed that, compared with percutaneous nephrolithotomy group,the patients in retrograde intrarenal surgery group had the following features:(1) the stone-free rate(95%confidence interval 0.88 to 1.02,P=0.15) and postoperative fever (95%confidence interval 0.54 to 1.67,P=0.85)were not significant difference between two groups;(2) The mean operation time was prolonged an average of 19.11 minutes( 95%confidence interval , 7.83 to 30.39, P<0.05);(3)The hospitaliza-tion stay was shortened an average of 2.1 days(95% confidence interval ,-3.08 to-1.11, P<0.05);(4) Incidence of bleeding of the retrograde intrarenal surgery group was lower(95%confidence interval, 0.06~0.68,P=0.01).Conclu-sion Compared with percutaneous nephrolithotomy,our results showed that retrograde intrarenal surgery shorten the hospitalization stay and reduced complications, which was significantly superior to percutaneous nephrolithotomy.