输尿管软镜联合负压吸引治疗感染性肾结石的Meta分析

Ureteroscopy combined with negative pressure suction for infectious renal calculus: a Meta analysis

摘要:

目的 探讨输尿管软镜联合负压吸引治疗感染性肾结石的有效性与安全性。方法 检索中国知网（CNKI）、维普（VIP）、中国生物医学数据库（CBM）、万方、PubMed、Web of Science、Embase、the Cochrane Central Trial Register of Controlled Trials等数据库从建库至2020年11月19日的关于输尿管软镜联合负压吸引治疗感染性肾结石的临床研究。由两位研究者独立进行文献筛选和资料提取，采用Cochrane协作网提供的偏倚风险评价表对随机对照实验进行质量评估，采用纽卡斯尔-渥太华量表对纳入的回顾性队列研究进行风险偏倚评估，RevMan 5.3软件进行Meta分析。结果 共纳入7篇文献，660例感染性肾结石患者（观察组336例，对照组324例）。Meta分析表明，观察组结石清除率较对照组高（O = 7.01，95%CI：3.70～13.27，P = 0.000）；观察组术后发热发生率较对照组低（O = 0.17，95%CI：0.07～0.41，P = 0.000）；观察组手术时间较对照组短（MD = -26.73，95%CI：-27.45～-26.02，P = 0.000）；两组患者结石大小比较，差异无统计学意义（MD = -0.07，95%CI：-0.57～0.42，P = 0.770）。结论 与常规输尿管软镜相比，输尿管软镜联合负压吸引治疗感染性肾结石能够提高结石清除率，减少术后发热等并发症的发生。

Abstract:

Objective Ureteroscope laser lithotripsy is the main method for the treatment of renal calculus, in this paper, we compare the safety and efficacy of ureteroscope combined with negative pressure suction versus no negative pressure suction for the treatment of infectious renal calculus.Methods The databases CNKI, VIP, CBM, Wanfang, PubMed, Web of Science, Embase and the Cochrane Central Trial Register of Controlled Trials were searched from their inception to November 19, 2020 for clinical studies on ureteroscopy combined with negative pressure suction for the treatment of infectious kidney stones. Literature screening and data extraction were performed independently by two researchers, the quality assessment of randomized controlled experiments was performed using the risk of bias assessment form provided by the Cochrane Collaboration, the Newcastle-Ottawa scale was used to assess the risk of bias of included retrospective cohort studies, and finally Meta-analysis of data was conducted using RevMan 5.3 software.Results 7 literatures involving 660 cases were included. Meta-analysis results showed that stone clearance in the observation group was higher than that in the control group (O = 7.01,95%CI: 3.70 ~ 13.27, P = 0.000), postoperative fever in the observation group was lower than that in the control group (O = 0.17, 95%CI: 0.07 ~ 0.41, P = 0.000); The operative time in the observation group was shorter than that in the control group (MD = -26.73, 95%CI: -27.45 ~ -26.02, P = 0.000);There was no significant difference in stone size between the two groups (MD = -0.07, 95%CI: -0.57 ~ 0.42, P = 0.770).Conclusion Compared with conventional ureteroscope, ureteroscope combined with negative pressure suction is able to improve the stone clearance rate and reduce postoperative fever and other complications in the treatment of infectious renal calculus.