非洲复杂结石管理中的当前做法和挑战:一个范围审查
Habeeb A Abdulrasheed1, Althea O George2, Petra S Ayobami-Ojo3
1Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR.
Cureus
|June 26, 2024
概括
在非洲,复杂结石的管理面临着挑战,皮革结石切除术 (PCNL) 是标准的,但开放式手术仍然很普遍. 改善获得泌尿外科护理的机会对于治疗鹿角石的更好的结果至关重要.
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) 是一種醫學專業.
- 公共卫生 公共卫生
背景情况:
- 复杂的结石,特别是鹿角结石,在非洲构成重大健康风险,包括经常性感染和损伤.
- 从历史上看,管理依赖于保守的方法或高发病率的手术,需要对当前的策略进行审查.
研究的目的:
- 审查非洲国家复杂结石和鹿角结石的挑战和管理策略.
- 评估不同手术干预的无石头率和并发症概况.
主要方法:
- 根据系统性审查的首选报告项目和元分析准则进行了范围审查.
- 在PubMed,非洲杂志在线 (AJOL) 和谷歌学者中进行了系统的搜索,确定了11项相关研究.
- 分析了1513名患者 (1,582个脏单位) 的数据,重点关注治疗方式,石头特征和结果.
主要成果:
- 皮肤穿神经切除术 (PCNL) 是主要的治疗方法 (71.3%),其次是开放式手术 (21.9%).
- 石头清除率各不相同:开放式手术 (83.7%),PCNL (82.8%),逆行性内手术 (RIRS) (92.8%) 和腹腔镜皮叶利索托米 (100%).
- 尽管PCNL的全球地位,公开手术 (30.8%) 的并发症率最高,而RIRS (4.7%) 的并发症率最低.
结论:
- 非洲的研究表明,由于医疗保健基础设施和社会经济因素的影响,人们持续依赖角石的开放手术.
- 像RIRS这样的最小侵入性技术显示出更低的并发症率.
- 解决医疗保健差异和改善获得先进泌尿外科护理的机会对于改善非洲结石管理至关重要.
相关概念视频
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