Meta-analysis of risk factors for subcapsular or perirenal hematoma after ureteroscopic lithotripsy
-
摘要: 目的 分析输尿管镜术后肾包膜下或肾周血肿的危险因素。方法 通过计算机检索万方、知网、维普、中国生物医学文献数据库、Pubmed、EMbase和Web of Science等数据库。检索从建库至2020年12月所有公开发表的关于输尿管镜术后继发肾包膜下或肾周血肿危险因素的研究文献，采用Revman 5.3软件进行统计分析。结果 根据统一的纳入和剔除标准，共纳入7篇文献，均为病例对照研究。血肿组103例，无血肿组7253例，筛选出6个危险因素，分别为合并尿路感染(OR=2.04，95%CI：1.75~2.38，P< 0.05)、合并肾积水(OR=5.72，95%CI：5.19~6.31，P< 0.05)、手术时间长(MD=9.35，95%CI：6.15~12.55，P< 0.05)、结石大小(MD=3.22，95%CI：2.17~4.27，P< 0.05)、感染性结石(OR=3.21，95%CI：1.52~6.77，P< 0.05)、女性患者(OR=3.14，95%CI：1.78~5.53，P< 0.05)。结论 合并尿路感染、合并肾积水、手术时间长、较大结石、感染性结石及女性患者均为输尿管镜术后继发肾包膜下或肾周血肿的危险因素。Abstract: Objective To analyze the risk factors of subcapsular or perirenal hematoma after ureteroscopy.Methods Wanfang, CNKI, VIP, CBM, Pubmed, Embase, Web of Science and other databases were searched by computer. All published literature on risk factors of subcapsular or perirenal hematoma secondary to ureteroscopy from the establishment of the database to December 2020 was searched, and statistical analysis was performed using Revman 5.3 software.Results According to the uniform inclusion and exclusion criteria, a total of 7 pieces of literature were included, all of which were case-control studies. There were 103 cases in the hematoma group and 7253 cases in the non-hematoma group. Six risk factors were screened out including urinary tract infection(OR=2.04, 95%CI: 1.75-2.38,P< 0.05), hydronephrosis(OR=5.72, 95%CI: 5.19-6.31,P< 0.05), long operation time(MD=9.35, 95%CI: 6.15-12.55,P< 0.05), stone size(MD=3.22, 95%CI: 2.17-4.27,P< 0.05), infectious calculi(OR=3.21, 95%CI: 1.52-6.77,P< 0.05)and female patients(OR=3.14, 95%CI: 1.78-5.53,P< 0.05).Conculsion Complications of urinary tract infection, hydronephrosis, long operation time, large calculi, infectious calculi and female patients were all risk factors for secondary subcapsular or perirenal hematoma after ureteroscopy.
-
Key words:
- ureteroscopy /
- subcapsular hematoma /
- perirenal hematoma /
- risk factors /
- meta-analysis
-
-
表 1 文献基本特征和质量评价
作者 年份 研究类型 病例数 对照数 危险因素 选择评价(星) 可比性评价(星) 暴露评价(星) NOS评价总分(星) 吕佳[3] 2018 病例对照 11 1694 1、2、3 3 2 3 8 李勋钢[4] 2020 病例对照 23 1405 1、2、3、4、5、9 3 2 3 8 李天[5] 2017 病例对照 18 1241 1、4、5、10、11 3 2 3 8 金志波[6] 2020 病例对照 19 1837 1、2、4、5 3 2 3 8 桂志明[7] 2017 病例对照 18 745 1、3、4、5 3 2 3 8 叶军[8] 2020 病例对照 10 290 4、5、10、11 3 2 3 8 Kao[9] 2016 病例对照 4 41 6、7、8 3 2 3 8 注：1，合并尿路感染; 2，合并肾积水; 3，高灌注压; 4，手术时间; 5，结石大小; 6，慢性肾病; 7，体重指数; 8，肾皮质厚度; 9，孤立肾; 10，女性患者; 11，感染性结石。 
下载: 导出CSV
-
[1] 叶章群, 吴柏霖. 关注泌尿系结石的治疗进展[J]. 中华泌尿外科杂志, 2012, 33(1): 6-9. doi: 10.3760/cma.j.issn.1000-6702.2012.01.001
[2] Johnson D B, Pearle M S. Complications of ureteroscopy[J]. Urol Clin North Am, 2004, 31(1): 157-171. doi: 10.1016/S0094-0143(03)00089-2
[3] 吕佳, 章越龙, 纪阿林, 等. 输尿管软镜碎石术后肾包膜下血肿的危险因素分析[J]. 重庆医科大学学报, 2018(4): 532-534. https://www.cnki.com.cn/Article/CJFDTOTAL-ZQYK201804013.htm
[4] 李勋钢, 张文圣. 输尿管镜钬激光碎石术后肾包膜下血肿相关危险因素探讨[J]. 江西医药, 2020, 55(7): 848-851. doi: 10.3969/j.issn.1006-2238.2020.07.016
[5] 李天, 孙祥宙, 李逊, 等. 输尿管软镜碎石术后并发肾周血肿的诊治[J]. 实用医学杂志, 2017, 33(5): 756-758. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ201705022.htm
[6] 金志波, 顾朝辉, 丁小举, 等. 输尿管软镜碎石术后肾周血肿形成的危险因素[J]. 中华实验外科杂志, 2020, 37(2): 349-350. doi: 10.3760/cma.j.issn.1001-9030.2020.02.044
[7] 桂志明, 柳建军, 苏劲, 等. 输尿管镜碎石术后继发肾包膜下血肿的相关风险因素[J]. 现代泌尿外科杂志, 2017, 22(5): 357-360. doi: 10.3969/j.issn.1009-8291.2017.05.011
[8] 叶军, 方建明, 杨伟锋. 输尿管软硬镜碎石术后继发肾包膜下血肿诊治分析[J]. 当代医学, 2020, 26(17): 128-129. doi: 10.3969/j.issn.1009-4393.2020.17.052
[9] Kao M, Wang C. Risk factors for developing a perirenal hematoma after flexible ureteroscopic lithotripsy[J]. Urological Science, 2016, 27(3): 166-170. doi: 10.1016/j.urols.2015.09.003
[10] 周莉, 廖冰, 曾虹, 等. 自发性肾包膜下血肿一例[J]. 中华肾脏病杂志, 2001, 17(6): 416. doi: 10.3760/j.issn:1001-7097.2001.06.023
[11] 杨斌, 张明聪, 程伟. 输尿管镜术后肾包膜下血肿1例并文献复习[J]. 国际泌尿系统杂志, 2019, 39(4): 692-694. doi: 10.3760/cma.j.issn.1673-4416.2019.04.032
[12] 刘星明, 吴元昱, 任胜强, 等. 体外冲击波碎石术后肾周血肿的原因分析[J]. 中华泌尿外科杂志, 2013, 34(8): 634-635. doi: 10.3760/cma.j.issn.1000-6702.2013.08.020
[13] 杨嗣星, 宋超. 再谈做好软性输尿管镜术需重视的关键问题[J]. 临床泌尿外科杂志, 2019, 34(4): 251-254. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW201904001.htm
[14] Zhong W, Leto G, Wang L, et al. Systemic inflammatory response syndrome after flexible ureteroscopic lithotripsy: a study of risk factors[J]. J Endourol, 2015, 29(1): 25-28. doi: 10.1089/end.2014.0409
[15] Bai J, Li C, Wang S, et al. Subcapsular renal haematoma after holmium: yttrium-aluminum-garnet laser ureterolithotripsy[J]. BJU International, 2012, 109(8): 1230-1234. doi: 10.1111/j.1464-410X.2011.10490.x
[16] 孙西钊, 吕建林, 叶章群. 泌尿系感染性结石的病因和诊治[J]. 中华泌尿外科杂志, 2010, 31(2): 141-143
-
图(7)
表(1)
计量
- 文章访问数: 658
- PDF下载数: 418
- 施引文献: 0