摘要
目的系统评价慢性鼻窦炎内镜鼻窦手术中植入全降解鼻窦药物支架的有效性及安全性。方法计算机检索PubMed、EMbase、Cochrane、中国生物医学文献数据库(CBM)、中国知网全文数据库(CNKI)、万方及维普数据库(VIP),检索时间为建库起至2020年11月,纳入有关慢性鼻窦炎内镜鼻窦手术中植入全降解鼻窦药物支架的随机对照试验,经文献筛选、资料提取和质量评价,对符合标准的文献提取相关效应指标,应用Revman 5.4软件进行Meta分析。结果共纳入7个临床随机对照试验,其中SES组661例,对照组661例。Meta分析显示,SES组术后干预次数少于对照组[RR=0.57,95%CI(0.49,0.66),P<0.05],息肉样变情况[RR=0.46,95%CI(0.36,0.58),P<0.05]、窦口狭窄/闭锁情况[RR=0.55,95%CI(0.43,0.71),P<0.05],炎症VAS评分[RR=-10.78,95%CI(-14.98,-6.57),P<0.05]、瘢痕形成/粘连情况[RR=0.57,95%CI(0.15,0.69),P<0.05]、中鼻甲侧位化情况[RR=0.36,95%CI(0.13,0.97),P<0.05]优于对照组;两组术后眼压比较,差异无统计学意义[MD=-0.21,95%CI(-0.78,0.36),P=0.47]。结论全降解鼻窦药物支架可有效控制炎症,利于减少窦口狭窄/闭塞、粘连/瘢痕、中鼻甲侧位化情况及术中干预次数,且无明显不良反应,因此在慢性鼻窦炎内镜鼻窦手术中植入全降解鼻窦药物支架是安全、有效、可行的,但其长期疗效及植入时机、植入浓度仍需进一步的临床研究。
Objective To systematically evaluate the effectiveness and safety of implanting a fully degradable sinus drug stent in endoscopic sinus surgery for chronic sinusitis.Methods Computer search of PubMed,EMbase,Cochrane,China Biomedical Literature Database(CBM),China National Knowledge Base(CNKI),Wanfang and VIP Database(VIP),The retrieval time is from the establishment of the database to November 2020.Randomized controlled trials involving the implantation of fully degradable sinus drug stents in endoscopic sinus surgery for chronic sinusitis were included.After literature screening,data extraction and quality evaluation,the relevant effect indicators of the literature that meet the standards were extracted,and the Revman 5.4 software was used for Meta analysis.Results A total of 7 clinical randomized controlled trials were included,including 661 cases in the SES group and 661 cases in the control group.Meta analysis showed that the number of postoperative interventions in the SES group was less than that in the control group[RR=0.57,95%CI(0.49,0.66),P<0.05],polypoid changes[RR=0.46,95%CI(0.36,0.58),P<0.05],sinus ostium stenosis/atresia[RR=0.55,95%CI(0.43,0.71),P<0.05],inflammation VAS score[RR=-10.78,95%CI(-14.98,-6.57),P<0.05],scar formation/adhesion[RR=0.57,95%CI(0.15,0.69),P<0.05],The lateralization of the middle turbinate[RR=0.36,95%CI(0.13,0.97),P<0.05]was better than that of the control group;there was no statistically significant difference between the two groups in postoperative intraocular pressure[MD=-0.21,95%CI(-0.78,0.36),P=0.47].Conclusion The fully degradable sinus drug stent can effectively control inflammation,help reduce sinus stenosis/occlusion,reduce adhesions/scars,postoperative intervention,lateralization of the middle turbinate,and no obvious adverse reactions.Therefore,it is safe,effective and feasible to implant a fully degradable sinus drug stent in endoscopic sinus surgery for chronic sinusitis,but its long-term efficacy,implant timing and implant concentration still need further clinical research.
作者
邱增玉
方平
汪东
陈善文
QIU Zeng-yu;FANG Ping;WANG Dong;CHEN Shan-wen(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China)
出处
《医学信息》
2021年第13期75-80,共6页
Journal of Medical Information
关键词
鼻窦炎
全降解鼻窦药物支架
息肉样变
Sinusitis
Fully degradable sinus drug stent
Polypoid degeneration
作者简介
邱增玉(1993.6-),男,安徽宿州人,硕士,住院医师,主要从事耳鼻咽喉科相关疾病的诊治工作;通讯作者:方平(1963.2-),女,安徽六安人,硕士,主任医师,教授,主要从事耳鼻咽喉科相关疾病的诊治工作。
