两种手术方法治疗女性压力性尿失禁治疗效果的Meta分析

目的:对阴道前壁修补术和经腹耻骨后膀胱颈悬吊术治疗压力性尿失禁患者的效果差异进行Meta分析。方法:检索1980年1月～2008年12月Pubmed、Cochrane图书馆、CNKI等文献资料库,纳入采用阴道前壁修补和经腹耻骨后膀胱颈悬吊术治疗压力性尿失禁的随机对照试验,采用Cochrane协作网提供的专用RevMan 4.2进行统计数据的Meta分析。结果:符合纳入标准的文献7篇、530例病人。Meta分析结果显示:阴道前壁修补术1年内失败率的相对危险度(RR)值为1.83,95%CI(1.31,2.56),差异有统计学意义(P<0.05);1～5年内失败率的RR值为2.28,95%CI(1.72,3.03),差异有统计学意义(P<0.05);5年后失败率的RR值为1.97,95%CI(0.84,4.64),差异无统计学意义(P>0.05)。结论:现有研究显示,对压力性尿失禁患者而言,采用经腹耻骨后膀胱颈悬吊术术后5年内失败率低。由于纳入研究存在选择性偏倚和测量性偏倚的可能性,因此期待更多高质量的随机双盲对照试验,提供坚实可靠的证据。

Meta analysis on curative effects of two kinds of surgical methods in treatment of female stress urinary incontinence

Objective:To analyze the curative effects of anterior colporrhaphy and transabdominal retropubic bladder neck suspension(RPBNS) in treatment of female stress urinary incontinence(SUI) by Meta analysis.Methods:The literatures of Pubmed,Cochrane library,and CNKI from January 1980 to December 2008 were retrieved,the patients undergoing anterior colporrhaphy and transabdominal RPBNS were included for randomized controlled trial,special RevMan 4.2 software provide by Cochrane collaboration was used for Meta analysis.Results:Seven literatures and 530 patients meeting the criterion were included.The results of Meta analysis showed that the relative risk ratio of failure rate within one year after anterior colporrhaphy was 1.83,95%CI(1.31,2.56),there was significant difference(P<0.05);the relative risk ratio of failure rate at 1-5 years after anterior colporrhaphy was 2.28,95%CI(1.72,3.03),there was significant difference(P<0.05);the relative risk ratio of failure rate after 5 years after anterior colporrhaphy was 1.97,95%CI(0.84,4.64),there was significant difference(P<0.05).Conclusion:Current studies show that the failure rate within five years after transabdominal RPBNS is low for the patients with SUI.Because of the probabilities of selective bias and measurement bias,more high quality random double-blind control experiments were needed to provide reliable evidences.