斜背与倾斜的儿科皮肤穿透性腎上腺切除术:一个系统的审查和元分析
Mohamed Ramez1, Esam A E Desoky2, Ahmed R El-Nahas1
1Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Arab journal of urology
|October 2, 2024
概括
这项元分析发现,对于儿科皮肤穿神经切除术 (PCNL) 的仰卧和俯卧位置具有相似的无结石率和并发症风险. 然而,卧卧的位置为接受PCNL的儿童提供了显著更短的操作时间.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 儿科手术 儿科手术
- 腎石病的管理方法
背景情况:
- 穿皮骨切除术 (PCNL) 是20毫米以上的儿科结石的主要治疗方法.
- 从历史上看,俯卧姿势是标准的,但卧卧姿势正在获得吸引力.
- 在儿童中,将卧姿与卧姿PCNL的安全性和有效性进行比较的证据有限.
研究的目的:
- 在儿科患者中进行元分析,评估卧姿与卧姿PCNL的安全性和有效性.
- 为了比较两种位置之间的无石头率,并发症发生率和手术时间.
主要方法:
- 在PubMed,Scopus,Web of Science和Cochrane图书馆的系统文献搜索,截至2024年2月28日.
- 包括3个随机和3个回顾性比较研究,涉及290名儿科患者.
- 使用Cochrane偏差风险和纽卡斯尔-太华尺度进行质量评估;使用Review Manager软件进行元分析.
主要成果:
- 在卧式和卧式PCNL之间没有观察到无结石率 (RR 1.08,p=0.11) 或整体并发症 (RR 0.93,p=0.76) 的统计学上显著差异.
- 卧卧的位置与明显缩短的操作时间有关 (SMD -0.99,p=0.005).
- 分析包括6项研究中的290名患者.
结论:
- 仰卧和俯卧的姿势在儿科皮肤穿神经切除术中表现出相似的疗效和安全性.
- 卧卧的方法在儿科PCNL中提供了潜在的优势,减少了手术时间.
- 进一步的研究可能会探索影响位置选择的患者和外科医生因素.
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