Department of Urology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China.
School of Medicine, Hangzhou Normal University, Hangzhou, 310016, China.
BMC Urol. 2023 Apr 4;23(1):56. doi: 10.1186/s12894-023-01226-5.
To compare the clinical efficiency and safety of emergency extracorporeal shock wave lithotripsy (eESWL) and delayed extracorporeal shock wave lithotripsy (dESWL) in the treatment of ureteral stones.
Cochrane Library, PubMed, Google Scholar, and Web of Science were searched from January 1, 1992 to September 30, 2022, and all comparative studies involving eESWL and dESWL for ureteral calculi were included. Statistical analysis was performed using Review Manager 5.3 software. Funnel plot was used to evaluated publication bias.
A total of 9 articles involving 976 patients diagnosed with ureteral stones were included. The results showed that the stone-free rate (SFR) after four weeks was significantly higher in the eESWL group than in the dESWL group [relative risk (RR) = 1.22, 95% confidence interval (CI): 1.13-1.32, P < 0.01]. In subgroup analysis of different stone locations, proximal ureteral calculi [RR = 1.25, 95% CI: 1.14-1.38, P < 0.01] and mid-to-distal ureteral calculi [RR = 1.18, 95% CI: 1.03-1.34, P < 0.05] all showed a higher SFR in the eESWL group. eESWL significantly shortened the stone-free time(SFT) [mean difference (MD) = -5.75, 95% CI: -9.33 to -2.17, P < 0.01]. In addition, eESWL significantly reduced auxiliary procedures [RR = 0.53, 95% CI: 0.40-0.70, P < 0.01]. No significant difference in complications was found between the two groups [RR = 0.90, 95% CI: 0.69-1.16, P > 0.05].
eESWL can significantly improve SFR, shorten SFT, and reduce auxiliary procedures.
比较急诊体外冲击波碎石术（eESWL）与延迟体外冲击波碎石术（dESWL）治疗输尿管结石的临床疗效和安全性。
计算机检索 Cochrane Library、PubMed、Google Scholar 和 Web of Science 数据库，检索时间从 1992 年 1 月 1 日至 2022 年 9 月 30 日，纳入比较 eESWL 与 dESWL 治疗输尿管结石的所有对照研究。采用 Review Manager 5.3 软件进行统计学分析。采用漏斗图评估发表偏倚。
共纳入 9 项研究，976 例输尿管结石患者。结果显示，eESWL 组术后 4 周的结石清除率（SFR）显著高于 dESWL 组[相对危险度（RR）=1.22，95%置信区间（CI）：1.131.32，P<0.01]。不同结石位置亚组分析显示，上段输尿管结石[RR=1.25，95%CI：1.141.38，P<0.01]和中下段输尿管结石[RR=1.18，95%CI：1.031.34，P<0.05]的 SFR 在 eESWL 组均较高。eESWL 组明显缩短了结石清除时间（SFT）[均数差（MD）=-5.75，95%CI：-9.33-2.17，P<0.01]。此外，eESWL 组明显减少了辅助治疗[RR=0.53，95%CI：0.400.70，P<0.01]。两组的并发症发生率无统计学差异[RR=0.90，95%CI：0.691.16，P>0.05]。
eESWL 可显著提高 SFR、缩短 SFT、减少辅助治疗。
