天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (8): 920-924.doi: 10.11958/j.issn.0253-9896.2015.08.025

• 循证医学 • 上一篇    下一篇

α1 受体阻滞剂用于ESWL 后排石有效性的Meta 分析

纪全松，张春东，王平   

  1. 中国医科大学附属第四医院
  • 收稿日期:2014-04-11 修回日期:2014-12-04 出版日期:2015-08-15 发布日期:2015-08-15
  • 通讯作者: 王平 E-mail:jiquansong1@163.com
  • 作者简介:纪全松（1989），男，硕士，主要从事泌尿外科方面研究

Efficacy of α1-blockers on expulsion urinary calculi post extracorporeal shock wave lithotripsy: a Meta-analysis

JI Quansong, ZHANG Chundong, WANG Ping   

  1. Department of Urology, The Fourth Affiliated Hospital of China Medical University, Liaoning 110032, China
  • Received:2014-04-11 Revised:2014-12-04 Published:2015-08-15 Online:2015-08-15

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摘要： 目的系统评价α1 肾上腺素能受体阻滞剂用于体外冲击波碎石技术（ESWL）后辅助排石的有效性。方法以Urinary calculi、Alpha-blocker、Randomized clinical trail、Extracorporeal shockwave lithotripsy 等为检索词，计算机检索PubMed、Embase、Cochrane 图书馆、CNKI 等数据库，系统收集α1 受体阻滞剂用于ESWL 后辅助排石的相关研究文献。对纳入的文献进行筛选及质量评价，提取数据后，以Revman5.0 软件进行Meta 分析，完成综合定量。结果本次研究共纳入14 篇随机对照实验文献，累计病例1 464 例。结果表明应用α1 受体阻滞剂后结石排出率提高（RR=1.21，95%CI：1.10~1.33，P < 0.05）；结石排出平均时间缩短（SMD= -1.23，95%CI：-2.09~-0.36)，P < 0.05）；但对于缓解腹绞痛发作的效果仍缺乏足够的支持（RR=0.54，95%CI：0.28~1.02，P=0.06）。结论α1 受体阻滞剂用于ESWL 后可有效提高结石排出率，缩短结石排出时间，可作为ESWL 术后辅助排石治疗方法。

关键词: 尿路结石, 肾上腺素能α拮抗剂, 碎石术, Meta 分析

Abstract: Objective To review the efficacy of α1-blocker in the treatment of urinary calculi post extracorporeal shock wave lithotripsy (ESWL). Methods Key words include Urinary calculi, Alpha-blocker, Randomized clinical trail, Ex⁃ tracorporeal shockwave lithotripsy, et al were searched against databases include Pubmed, Embase, Cochrane Library data⁃ bases and CNKI. All studies that reported effect of α-blockers post ESWL were eligible for the analysis. Data was extracted through quality assessment and data filtering, then were analysed using RevMan 5.0. Results Fourteen randomized clinical trails with a total of 1 464 patients met the inclusion criteria. Pooled analysis showed a better stone clearance and shorter in⁃ terval between stone fragment discharges (RR=1.21, 95%CI:1.10-1.33, P < 0.05) and (SMD= -1.23, 95%CI:-2.09 - -0.36, P < 0.05) respectively after α1-blocker administration. However, evidence is still not convincible that it can reduced the fre⁃ quency of colic episodes (RR= 0.54，95%CI:0.28-1.02, P=0.06). Conclusion α1-blockers facilitates the expulsion of uri⁃ nary calculi shown by a higher expulsion rate, a shorter expulsion interval during treatment. Adjunctive therapy with α1- blockers after ESWL is effective in the treatment of urinary calculi.

Key words: urinary calculi, adrenergic alpha-antagonists, lithotripsy, Meta-analysis