微通道和标准通道经皮肾镜碎石术中肾盂内压力、术后发热及手术效果比较的meta分析

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Abstract Objective To systematically evaluate the safety and efficacy of surgery between mini-tract percutaneous nephrolithotomy(MPCNL)and standard-tract percutaneous nephrolithotomy(SPCNL)in the treatment of upper urinary tract calculi.Methods Pubmed,Cochrane Library,Embase,Wanfang,CNKI and VIP databases were searched for randomized controlled trials related to percutaneous nephrolithotomy for patients with upper urinary calculi from the establishment of the database to December 1,2019.Two evaluators selected the trials according to the inclusion and exclusion criteria,and the data were extracted and analyzed by Revman 5.3 software for meta analysis.Results Four randomized controlled trials were included in this study,with a total of 375 patients.The results showed that the renal pelvis pressure(RPP)in MPCNL group was higher than that in SPCNL group,and the difference was statistically significant(MD=10.38,95%CI: 6.37-14.38, P＜0.000 01).The postoperative fever(POF)rate in MPCNL group was higher than that in SPCNL group,the difference was statistically significant(OR=2.43,95%CI: 1.39-4.27, P=0.002).There was no significant difference in the operative time between the MPCNL group and the SPCNL group(MD=5.69,95%CI:-4.54-15.91, P=0.28).There was no significant difference in stone clearing rate between MPCNL group and SPCNL group(OR=1.06,95%CI: 0.61-1.86, P=0.83).Conclusion Compared with SPCNL,MPCNL can increase intraoperative RPP and the patients′ POF rate.The two have similar surgical effect such as operation time and stone clearing rate.Therefore,the intraoperative detection of RPP by MPCNL is of great significance to ensure patient safety and reduce postoperative complications.

Key words： Standard-tract percutaneous nephrolithotomy Mini-tract percutaneous nephrolithotomy Renal pelvis pressure Systematic review Meta analysis

Received: 02 April 2021

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