标准通道和微通道PCNL在不同肾盂压力下治疗感染性肾结石效果的M eta分析

摘要

Objective: To compare the efficacy of percutaneous nephrolithotomy ( PCNL) for the treatment of nephrolithiasis with standard channels ( F24-F34 ) and micro-channels ( F16-F18 ) .Methods: Randomized con-trolled trials ( RCTs) of PCNL nephrolithiasis were retrieved from PubMed , Embase, CNKI, Wanfang and other medical databases .Literatures were independently extracted by two workers .Stata 14 .0 software was used for this Meta-analysis.Explore the efficacy of standard channel and micro-channel PCNL(MPCNL) treatment.Results:In this study , 11 randomized controlled trials involving 2152 patients with nephrolithiasis were analyzed .The Meta-analysis showed that the complications of hypo renal pelvic pressure RR =0.63(95％CI:0.63 to 1.06) and blood loos RR=-0.94(95％CI:-1.29 to -0.59) for MPCNL, complications RR=0.39(95％ CI:0.21 to 0.71) and blood loss RR =-1.48 (95％CI:-1.87 to -1.08) for PCNL.Conclusion: MPCNL is less effective than PCNL in terms of stone clearance rate and postoperative complication rate , but it can reduce postoperative complica-tions and intraoperative blood loss with hypo renal pelvic pressure .%目的:对比分析标准通道(F24～F34)和微通道(F16～F18)经皮肾镜(PCNL)治疗感染性肾结石的效果.方法:在PubMed、Embase、CNKI、万方等医学数据库,检索PCNL治疗肾结石的临床随机对照试验(RCT),由两位工作者独立提取文献数据,利用Stata 14.0软件对纳入文献进行Meta分析,探索标准通道和微通道的治疗效果.结果:本研究共纳入11篇随机对照试验文献,包括2152例肾结石病人,Meta分析结果显示低肾盂压力下微通道PCNL(MPCNL)并发症RR=0.63(95％CI:0.63～1.06),术中出血量RR=-0.94(95％CI:-1.29～-0.59);PCNL并发症RR=0.39(95％CI:0.21～0.71),术中出血量RR=-1.48(95％CI:-1.87～-1.08).结论:低肾盂压力下可以减少术后并发症及术中出血量;但MPCNL的治疗效果(结石清除率及术后并发症发生率)与PCNL比较没有明显的优势.