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通过皮肤利切除术中单次和逐渐扩张技术的比较:系统性审查和元分析

Kharisma Prasetya Adhyatma¹, Muhammad Ainul Mahfuz², Dianita Halimah Harahap¹

¹Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara - Adam Malik Hospital, Medan, Indonesia.

Central European journal of urology

|December 1, 2025

概括

通过皮肤瘤切除术 (PCNL) 的单次扩张 (OD) 与逐渐扩张 (MD) 相比,显著减少并发症. 这种更安全的结石管理方法显示了可比的无结石率,因此需要在不同的环境中进一步调查.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
最少侵入性的手术
腎石病的管理方法

背景情况:

穿皮骨切除术 (PCNL) 是大型或复杂结石的关键治疗方法.
扩展方法,单射 (OD) 与多射 (MD) 相比,影响PCNL的安全性和有效性.
优化PCNL技术对于改善患者治疗结果至关重要.

研究的目的:

为了比较一次性扩张 (OD) 与逐渐扩张 (MD) 在光学引导的PCNL中的安全性和有效性.
评估OD和MD方法之间的并发症率和无结石率.
为促进结石管理技术的进步提供信息.

主要方法:

一个符合PRISMA的随机对照试验和队列研究的元分析.
包括接受常规PCNL的成年患者,不包括超声导向或迷你PCNL.
搜索了主要的数据库 (PubMed,Scopus等) 从2008年起;由两个独立审查员提取的数据.
使用Cochrane ROB2和ROBINS-I评估研究质量;与审查经理分析数据 5.4.4.

主要成果:

分析了16项研究,包括OD组的572名患者和MD组的581名患者.
一次性扩张 (OD) 表明并发症率显著降低 (RR = 0.77; p = 0.01).
在OD和MD之间没有观察到无结石率的统计学上显著差异 (RR = 1.02; p = 0.49).

结论:

一次性扩张是成年人常规PCNL的更安全的选择,由减少并发症证明.
需要进一步的研究来验证这些发现在不同的临床环境.
OD可能代表PCNL技术的进步,用于管理结石.

关键词:

这是PCNL的PCNL.扩张扩张是什么多个多个多个多个多个多个多个多个.一次性的一枪.一个连续的顺序.一个步骤的单步骤.

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