【摘要】 目的:系统评价袖套式包皮环切术对治疗男性阴茎包皮过长及包茎的疗效。方法:通过计算机检索PubMed,Cochrane Library,CNKI,CBM和Wanfang数据库中自建库至2012年9月中公开发表的关于比较袖套式包皮环切术与传统包皮环切术疗效的随机对照试验(RCT)。由2名评价者独立进行质量评价及资料提取后,采用RevMan 5.1软件对纳入的RCT进行Meta分析。结果:共纳入9个RCT,合计8 353例受试患者。Meta分析结果显示:与传统环切术相比,袖套组的手术时间较长[SMD=2.89,95%CI(1.67,4.11),P<0.001],但术中出血量少[SMD=-5.05,95%CI(-6.90,-3.21),P<0.001]、术后疼痛时间短[SMD=-2.05,95%CI(-3.59,-0.51),P=0.009]、水肿发生率低[OR=0.14,95%CI(0.06,0.33),P<0.001]、出血/血肿发生率低[OR=0.14,95%CI(0.06,0.32),P<0.001]、感染发生率低[OR=0.27,95%CI(0.11,0.64),P=0.003]。结论:袖套式包皮环切术手术时间较传统环切术长,但其术中失血量少、术后疼痛时间短、术后并发症的总发生率比传统术式低。因此,袖套式包皮环切术是一种疗效安全可靠、并发症少的治疗男性包茎、包皮过长的微创术式。但鉴于纳入研究的证据强度有限,有必要进一步开展高质量、大样本的临床RCT进一步评价。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of the sleeve circumcision for redundant prepuce or phimosis.Methods The PubMed,Cochrane Library,CNKI,CBM and Wanfang databases were searched up to September 2012 and only collected randomized controlled trials(RCT) to compare the conventional circumcision with the sleeve circumcision.After quality assessment and data extraction by two reviewers independently,a meta-analysis was performed by using RevMan 5.1 software.Results Nine RCTs involving 8 353 participants were included.Comparison with the conventional technique,the results showed that sleeve circumcision could lengthen the duration of operation;however,sleeve circumcision could reduce the loss of blood,alleviate postoperative pain,fewer number of postoperative edema,reduce incidence of postoperative hematoma,and lower postoperative infections.Conclusion The operation time of sleeve circumcision is longer than conventional circumcision,however,sleeve circumcision is superior in reducing the loss of blood,alleviating postoperative pain,and lower overall incidence of complications.Therefore,the sleeve circumcision is an effective and minimally invasive treatment for male patients with phimosis or redundant prepuce,but due to the limitations of included RCTs,high quality and large sample size clinical RCTs are suggested in future.更多还原