商环包皮环切术治疗包茎或包皮过长的 Meta 分析

摘要

Objectives:To evaluate the efficacy of Chinese Shang Ring circumcision for phimosis or redun-dant prepuce.Methods:Related original studies with only randomized controlled trials published by January 2014 were searched in the databases,such as PubMed,EMBASE,OVID,the Cochrane Library,CNKI,VIP,CBMand Wanfang.Two reviewers independently screened the studies for eligibility and extracted the data from the eligible studies.Meta -analysis was performed by RevMan5.2.5 software.Results:Five studies involving 1273 patients were included.In comparison with the conventional technique,fewer time of surgery [SMD =-7.17,95% CI(-7.53,-6.81),P <0.00001],fewer number of postoprative bleeding [OR =0.13,95%CI(0.03,0.51),P =0.003],lower postoperative infection [OR =0.14,95% CI (0.04,0.46),P =0.001]and fewer number of ap-pearance defect [OR =11.41,95% CI (3.42,38.10),P <0.0001 ]were found in the Shang Ring group. Conclusions:The evidence available indicates that Chinese Shang Ring circumcision is an effective and minimally invasive treatment for phimosis or redundant prepuce.%目的：评价商环包皮环切术治疗包茎或包皮过长的疗效及安全性。方法：计算机检索 CBM、PubMed、Cochrane Library、Ovid、VIP、CNKI、万方及 EMBASE 数据库，检索时间截止2014年1月，纳入所有比较商环包皮环切术与包皮环切术治疗包茎或包皮过长的随机对照试验，2人独立进行筛选及资料提取，用RevMan5.2.5软件进行 Meta 分析。结果纳入5个研究。结果：与传统包皮环切术相比，商环包皮环切术的手术时间短[标准化均数差＝－7.17，95％可信区间（－7.53，－6.81）]、术后出血发生率低[比值比＝0.13，95％可信区间（0.03，0.51）]、感染少[比值比＝0.14，95％可信区间（0.04，0.46）]，术后外观好[比值比＝11.41，95％可信区间（3.42，38.10）]。结论：本研究证实商环包皮环切术是一种手术时间短，术后水肿及出血发生率低，术后外形美观的微创手术。但受纳入研究样本量的限制及发表偏倚的影响，上述结论尚需开展更多大样本多中心的随机双盲对照试验来加以验证。