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目的系统评价经输尿管软镜取石术(FURL)与经皮肾镜取石术(PCNL.)治疗肾下极10~20mm结石的有效性和安全性。方法计算机检索The Cochrane Library、Pubmed、中国知网、维普及万方数据库,全面收集有关FURL和PCN L比较治疗肾下极结石的临床试验。由2位研究者独立进行文献筛选、资料提取和纳入研究的方法学质量评价后,采用RevMan 5.1软件进行Meta分析。结果共纳入5篇研究,均为非随机对照试验,共计379例患者。Meta分析结果显示:PCNL.的结石清除率(OR=3.62,95%CI:1.75~7.49,P<0.05)、手术时间(MD=-20.25,95%CI:-31.10~-9.41,P<0.05)明显优于FURL,而住院时间(MD=1,95%CI:0.63~1.37,P<0.05)方面则长于FURL,在手术所致发热、出血、输尿管结石等并发症方面两者均无统计学差异(均P>0.05)。结论现有证据显示,在结石清除率、手术时间方面,PCNL.优于FURL;而在住院时间方面,FURL则优于PCNL,两者在手术所致发热、出血、输血、输尿管结石等并发症方面并无明显差异。
Objective To evaluate the efficacy and safety of ureteroscopic lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL.) In the treatment of 10 ~ 20mm stones of the lower kidney. Methods The Cochrane Library, Pubmed, CNKI, VIP and Wanfang databases were searched by computer. A comprehensive clinical trial on FURL and PCN L for the treatment of extrahepatic stones was collected. Two independent reviewers conducted literature review, data extraction and methodological quality evaluation of the study. Meta-analysis was performed using RevMan 5.1 software. Results A total of 5 studies were included, all of which were non-randomized controlled trials, totaling 379 patients. The results of Meta analysis showed that the stone clearance rate (OR = 3.62, 95% CI: 1.75-7.49, P <0.05) of PCNL. The time of operation (MD = -20.25,95% CI: -31.10-9.41, P <0.05 ) Was significantly better than FURL, while hospital stay (MD = 1,95% CI: 0.63-1.37, P <0.05) was longer than FURL, with no statistical differences in terms of complications such as fever, bleeding, and ureteral calculi Learning difference (all P> 0.05). Conclusions The available evidence shows that PCNL is superior to FURL in terms of stone clearance and operative time, while FURL is superior to PCNL in terms of length of stay, both of which are associated with complications such as fever, bleeding, blood transfusion and ureteral calculi There are no obvious differences.