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[新生儿包皮环切术与生命第一年尿路感染的风险。一项荟萃分析]

[Circumcision in the newborn child and risk of urinary tract infection during the first year of life. A meta-analysis].

作者信息

Amato D, Garduño-Espinosa J

机构信息

Departamento de Nefrología, Hospital de Pediatría, Instituto Mexicano del Seguro Social, D.F.

出版信息

Bol Med Hosp Infant Mex. 1992 Oct;49(10):652-8.

PMID:1449623
Abstract

To assess if neonatal circumcision may decrease the incidence of urinary tract infection (UTI), published papers on these topics were reviewed, to address their methodological shortcomings, and to analyze them in individual and grouped form. A systematic search of the papers on circumcision and UTI was conducted in Index Medicus (1975-1991) and MEDLINE (1988-1991). Six papers were included in the meta-analysis because all of them presented original data obtained from groups of patients. All of the elected articles were considered in individual and grouped form to calculate odds ratio (OR) and confidence interval at 95% (CI 95%). The number of patients included in each paper ranged from 112 to 219,775. Clustering of the articles enabled us to obtain a global sample number of 221,799 patients. In each individual article there was a higher risk of UTI in uncircumcised patients (OR from 10.82 to 156.42). Global risk obtained from the six clustered papers was of 13.05 with a CI 95% from 10.86 to 15.70. Uncircumcised males have low risk of UTI during their first year of life, but the risk may decrease even more with circumcision. This conclusion may not be considered as definitive because of the methodological shortcomings of the papers reviewed. Recommendation of routinely circumcision to all newborns in not justified with these data.

摘要

为评估新生儿包皮环切术是否可降低尿路感染(UTI)的发生率,我们回顾了关于这些主题的已发表论文,以解决其方法学上的不足,并以单独和分组形式对其进行分析。在《医学索引》(1975 - 1991年)和MEDLINE(1988 - 1991年)中对有关包皮环切术和UTI的论文进行了系统检索。六项研究被纳入荟萃分析,因为它们均呈现了从患者群体中获得的原始数据。所有入选文章均以单独和分组形式进行考量,以计算比值比(OR)和95%置信区间(CI 95%)。每篇论文纳入的患者数量从112至219,775不等。对这些文章进行聚类分析使我们能够获得一个包含221,799名患者的总体样本。在每篇单独的文章中,未行包皮环切术的患者发生UTI的风险更高(OR从10.82至156.42)。从六项聚类分析的论文中得出的总体风险为13.05,CI 95%为10.86至15.70。未行包皮环切术的男性在其生命的第一年发生UTI的风险较低,但包皮环切术可能会进一步降低这种风险。由于所回顾论文存在方法学上的不足,这一结论可能不被视为定论。基于这些数据,向所有新生儿常规推荐包皮环切术是不合理的。

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