摘要
目的探讨一次性包皮切割缝合器与传统包皮环切术疗效及安全性。方法通过计算机检索中文数据库中国期刊全文数据库、维普、万方和中国生物医学文献数据库和英文数据库MEDLINE(2012~2015)、EMBASE(2012~2015)和协作网系统评价资料库CDSR,由2人分别对文献进行检索及筛选、对纳入文献行数据提取,利用Revman 5.3.0软件进行统计分析。结果本研究共纳入9篇相关文献,其中中文7篇,英文2篇。结果显示一次性包皮环切缝合器在手术时间(MD=19.96,95%CI:16.23~23.70,P〈0.0001)、术中出血量(MD=10.23,95%CI:8.49~11.97,P〈0.0001)、术后疼痛评分(MD=2.01,95%CI:0.75~3.27,P=0.002)、愈合时间(MD=3.74,95%CI:2.06~5.42,P〈0.0001)以及外观满意率(RR=0.70,95%CI:0.50~0.98,P=0.04)均优于传统包皮环切术,总并发症发生率(RR=1.84,95%CI:0.95~3.56,P=0.07)和伤口术后发生血肿率(RR=1.67,95%CI:0.87~3.22,P=0.12)的差异没有统计学意义,但一次性包皮环切缝合器能明显降低术后切口发生感染的风险(RR=3.44,95%CI:1.24~9.57,P=0.02)。结论与传统的包皮环切术相比,一次性包皮环切缝合器在减少手术时间、术中出血量、术后疼痛、提高术后外观满意率及降低术后切口发生感染的风险,值得推广。
Objective To evaluate the efficacy and safety of disposable circumcision suture device(DCSD)and conventional circumcision(CC)in the treatment of redundant prepuce or phimosis.Methods Databases including MEDLINE,EMBASE,Cochrane Database of Systematic Reviews,Wanfang Data,CNKI,Weipu Data and Chinese Biomedical Database(CBM)were searched for studies on DCSD and CC for redundant prepuce or phimosisc by two independent reviewers.Data extracted were then analyzed with Revman 5.3.0 software.Results A total of 9 studies involving 1853 patients were included,with 7 Chinese articles and 2 English ones.The results showed DCSD had more advantages over CC in operation time(MD=19.96,95%CI:16.23-23.70,P〈0.0001),blood loss(MD=10.23,95%CI:8.4911.97,P〈0.0001),postoperative pain score(MD=2.01,95%CI:0.75-3.27,P=0.002),healing time(MD=3.74,95%CI:2.06-5.42,P〈0.0001),and patients'satisfaction(RR=0.70,95%CI:0.50-0.98,P=0.04).There were no statistical difference in terms of total complication rate(RR=1.84,95%CI:0.95-3.56,P=0.07)and wound hematoma(RR=1.67,95%CI:0.87-3.22,P=0.12),but DCSD could remarkably decrease the risk of postoperative infection(RR=3.44,95%CI:1.24-9.57,P=0.02).Conclusion DCSD is more advantageous than CC in operation time,blood loss,postoperative pain,and patients'satisfaction.It also reduces the risk of wound infection after operation.It is worthy of clinic application.
作者
陈勇吉
曹德宏
柳良仁
魏强
CHEN Yong-ji;CAO De-hong;LIU Liang-ren;WEI Qiang(Department of Urology,Institute of Urology,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《现代泌尿外科杂志》
CAS
2016年第10期741-747,共7页
Journal of Modern Urology
基金
国家自然科学基金(No.81370855
No.81460148
No.81200551)
四川省科技厅基金(No.2013SZ0006,No.2015SZ0230)
