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目的系统评价完全无管化经皮肾镜取石术相对于标准经皮肾镜取石术的安全性与可行性。方法搜集国外的有关完全无管化与标准经皮肾镜随机对照对照试验的文献，对符合要求的的试验并采用Reman5．1软件进行meta分析。结果最后纳入4篇RCT ，共315名患者。Meta分析结果显示：手术时间、住院时间、恢复正常活动的时间方面完全无管化优于标准 PCNL ；血红蛋白下降、输血发生率、结石清除率两组进行比较时，差异无统计学意义。结论完全无管化经皮肾镜取石术对于选择性患者在缩短住院时间、恢复正常活动时间及手术时间方面较标准经皮肾镜取石术更具优势。由于本系统评价纳入研究数量少，且有存在选择偏倚、实施偏倚与发表偏倚的可能性，故应谨慎看待以上结论，期待更多高质量的随机对照试验提供更可靠的证据。“,” Objective To systematically review the efficiency and security of totally PCNL .Methods The randomized controlled trials of totally tubeless and standard PCNL were retrieved .We used The RevMan 5 .1 software for meta-analysis .Results 4studies involving 315 patients were in-cluded .For the hospital stay ,operating time ,returning to work time ,totally tubeless group was shorter than standard PCNL group .For blood trans-fusion rate ,stone free rate ,postop erative Hb drop ,totally Tubeless and stand PCNL were nonsignificant .Conclusion totally Tubeless PCNL can sig-nificantly reduce the hospital stay time and operating time ,shorten the returning to work time .There is a moderate possibility of selection bias ,per-formance bias and publication bias in this review ,because of the small number of the included studies ,which weakens the strength of the evidence of our results .Better evidence from more high -quality randomized controlled trials is needed .