在阻塞性尿路石症的二次性水解中,穿皮性瘤与尿路支架相比:系统性审查和元分析
Andreia Cardoso1, Aparício Coutinho2, Gonçalo Neto2
1Department of Urology, Hospital de Braga, Braga, Portugal.
Asian journal of urology
|April 29, 2024
概括
穿皮瘤切除术 (PCN) 可能比逆行尿路支架 (RUS) 更好,用于紧急排水上部尿路石头,提供更好的生活质量和更少的尿路症状. 建议进行进一步的研究.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學.
- 手术干预 手术干预
背景情况:
- 上部泌尿道结石阻塞并发症需要紧急排水.
- 在逆行性尿路支架 (RUS) 和通皮瘤切除术 (PCN) 之间进行排水的选择尚未确立.
- 目前文献中缺乏对RUS与PCN的比较结果.
研究的目的:
- 为了比较RUS和PCN在治疗阻塞性尿质病的疗效和患者结局.
- 评估尿路症状,生活质量 (QoL),自发性石头通过和住院时间的差异.
- 为了确定一个排水方式是否优于复杂的上部尿路结石.
主要方法:
- 从2019年6月到2022年11月,在MEDLINE和其他数据库中进行了系统的文献搜索.
- 包括的研究是随机对照试验或队列研究,比较PCN和RUS用于阻塞性尿病.
- 结果措施包括尿路症状,QoL,自发性石头通道和住院时间.
主要成果:
- 其中包括7项研究,大多数研究质量中等至高.
- 生活质量 (QoL) 在RUS中普遍较差,一项研究显示了统计学上显著的负面影响.
- 接受RUS治疗的患者报告说,干预后尿道症状显著增加.
- PCN与自发石头通过的可能性更高有关.
- 住院时间在各个研究中显示出不一致的结果.
结论:
- 穿皮瘤切除术 (PCN) 似乎比逆行尿道支架 (RUS) 更好地容忍.
- PCN可能会对患者感知到的QoL的影响较小,并且手术后尿道症状较少.
- 需要进一步进行高质量的随机受控试验,采用更大的样本大小来证实这些发现.
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