非那雄胺治疗经尿道前列腺切除术中出血的Meta分析.pdfVIP

Chin 1 Evid—based Med 2008，8(6)：456—460 非那雄胺治疗经尿道前列腺切除术中出血的 Meta分析 朱育春 钟 玲z魏 强p 1．I~J Jl大学华西医院泌尿外科f成都 610041)2．四川大学华西临床医学院 摘要 目的 评价非那雄胺治疗经尿道前列腺切除术中出血的效果。方法 按Cochrane协作网工作手册的 要求，制定相应的纳入／排除标准及检索策略。检索MEDLINE(1966～2005)、EMbase(1984～2004)、CBM f 1980～2005)、Cochrane图书馆(2005年第4期)以及相关杂志和学位论文，收集非那雄胺治疗经尿道前列腺 切除术中出血的随机和非随机对照试验。对纳入的试验进行方法学质量评价。采用统一的表格由两名评价员 独立进行资料提取，用RevMan4．2软件进行数据处理和分析。结果 最终纳入5篇文献：4个为随机对照试验， 1个为非随机对照试验。3个随机对照试验的质量等级均为C级。Meta分析结果显示，两组年龄、下尿路症状评 分、前列腺特异抗体水平及术前前列腺体积、术中切除组织量均可比(P0．05)的情况下，非那雄胺组术中出血量 WMD一85．44．95％CI(一117．31，一53．58)]、每克切除前列腺组织出血量[WMD一3．5，95％CI(一6．34，一o．58)J，术前 术后血色素降低量[WMD一1．61，95％CI(一1．96，一1．26)]均少于对照组。结论 现有证据表明，行经尿道前列腺 切术前服用非那雄胺能有效减少术中出血。 关键词 非那雄胺；经尿道前列腺切除术；出血；良性前列腺增生(症)；Meta分析 Meta—analysis of Finasteride for Perioperative Bleeding in Patients Undergoing Transurethral Resection of Prostate ZHU Yu—chun’，ZHONG Ling ，WEI Qiang’ 1．Department ofUrology,West China Ho~ital ofSichuan University,Chengdu 610041，China； 2．West China School ofMedicine,Sichuan University,Chengdu 610041，China Abstract Objective To assess the efficacy of finasteride in treating perioperative bleeding in patients undergoing transurethral resection of the prostate(TURP)．Methods We searched MEDLINE(1966 to 2005)，EMBase(1984 to 2004)，CBM(1980 to 2005)，The Cochrane Library(Issue 4，2005)and relevant journ~s to identify clinical trials involving finasteride in patients undergoing TURP．We also checked the references in the reports of each included tria1．The quality of randomized controlled trials(RCTs)was assessed according to the methods recommended by The Cochrane Collaboration， and the quality of non—RCTs was assessed based on the methods recommended by Jiang—ping Liu，Stroup and Halley．Two reviewers extracted data independently and data ana1vses were conducted with The Cochrane Collaboration’s RevMan 4．2． Result We included 4 RCTs and 1 non—RCT．The quality of 3 RCTs was g