Meta-analysis Of The Efficacy Of Citrate In Patients With Upper Urinary Calculi After ESWL Operation

Objective(s):Urological calculus is a common and frequentlyoccurring disease in urology,and the incidence of which is increasing year by year.With the development of the research on the etiology of urinary calculi,especially the in-depth research on the analysis of the composition of calculi and the evaluation of urine metabolism in recent years,more and more attention has been paid to the causes,drug treatment and prevention of urinary calculi.In the traditional treatment of urinary calculi,extracorporeal shock wave lithotripsy is an important treatment,and the effect of citrate drugs in adjuvant or conservative treatment and prevention of postoperative lithotripsy for patients with urinary calculi is worthy of affirmation.By searching the current mainstream Chinese and English databases,this study conducted a Meta analysis of literatures on the efficacy of citrate in patients with upper urinary tract calculi after ESWL operation,so as to provide a theoretical basis for the treatment and prevention of patients with upper urinary tract calculi after ESWL operation.Methods:Through analyzing Chinese databases:CNKI,Wanfang Database,VIP Database,Chinese Biomedical Document Service System,and foreign language databases:A literature search was conducted on PubMed,Embase,Websinence,Cochranelibrary,Metrix,and domestic and foreign clinical trial registration platforms.Chinese and English randomized controlled trials(RCTs)containing citrate in the treatment of urinary calculi were searched by subject words and free words.The primary outcome index was the effective rate and recurrence rate of patients treated with citron after ESWL.According to the literature inclusion criteria,relevant literatures were included and relevant information was extracted.A total of 7 RCT studies involving 1301 patients were retrieved,including 647 patients receiving citrate drugs,654 blank controls,and 654 placebo controls.On the premise of using the Cochrane systematic evaluation tool for literature quality assessment and I2 statistics to test the heterogeneity,ReviewManager5.3 software was used for Meta analysis.Results:The results of Meta-analysis showed that the recurrence rate of ESWL patients treated with citrate was lower than that of the control group[Z=8.10,P<0.01],and the RR value and 95%confidence interval were 0.16[0.10,0.25].In another study comparing efficacy,patients receiving citrate after ESWL were more effective than conventional conservative treatment or no medication[Z=5.90,P<0.01],with a combined RR of 1.58,95%confidence interval[1.36,1.84].Conclusion(s):Citrate is effective in the treatment of patients with upper urinary tract calculi after ESWL operation,and can effectively reduce the recurrence rate of calculi.