Abstract：
BACKGROUND: To comprehensively evaluate the reported clinical effectiveness of platelet-rich plasma (PRP) in patients with chronic sinusitis undergoing endoscopic sinus surgery (ESS).
METHODS: We performed a systematic review and meta-analysis of randomised controlled trials (RCTs). Five digital online databases (PubMed, Scopus, Web of Science, Google Scholar and Cochrane CENTRAL) were searched from inception up to 1st May 2023. Our specific outcomes involved postoperative nasal endoscopy scores measured via Lund-Kennedy score or Meltzer score, olfactory sensation scores and pre-operative anosmia duration. All data were pooled as standardised mean difference (SMD) with a 95% confidence interval (CI), using the RevMan software.
RESULTS: Six RCTs were included in this systematic review and meta-analysis, with a total of 169 patients. The risk of bias in the included RCTs was low in three RCTs, some concerns in one RCT and high risk in two RCTs. The overall analysis of the postoperative nasal endoscopy scores showed that the PRP group had lower scores compared to the control group (n = 3 RCTs, SMD = -1.19; 95% CI [-1.94, -0.44], p = .002). There was no significant difference between the PRP and control groups regarding anosmia duration (n = 2 RCTs, SMD = 0.21; 95% CI [-0.17, 0.59], p = 0.28) or olfactory sensation scores, despite the PRP group having higher scores (n = 2 RCTs, SMD = 0.53; 95% CI [-0.32, 1.39], p = 0.22).
CONCLUSIONS: This study highlights the potential advantages of using PRP as an additional treatment for individuals with chronic sinusitis undergoing ESS. The improvements associated with PRP include facilitating wound healing, reducing inflammation and enhancing surgical outcomes. To optimise the use of PRP in clinical settings, future research should focus on conducting larger trials with standardised protocols.
METHODS: We performed a systematic review and meta-analysis of randomised controlled trials (RCTs). Five digital online databases (PubMed, Scopus, Web of Science, Google Scholar and Cochrane CENTRAL) were searched from inception up to 1st May 2023. Our specific outcomes involved postoperative nasal endoscopy scores measured via Lund-Kennedy score or Meltzer score, olfactory sensation scores and pre-operative anosmia duration. All data were pooled as standardised mean difference (SMD) with a 95% confidence interval (CI), using the RevMan software.
RESULTS: Six RCTs were included in this systematic review and meta-analysis, with a total of 169 patients. The risk of bias in the included RCTs was low in three RCTs, some concerns in one RCT and high risk in two RCTs. The overall analysis of the postoperative nasal endoscopy scores showed that the PRP group had lower scores compared to the control group (n = 3 RCTs, SMD = -1.19; 95% CI [-1.94, -0.44], p = .002). There was no significant difference between the PRP and control groups regarding anosmia duration (n = 2 RCTs, SMD = 0.21; 95% CI [-0.17, 0.59], p = 0.28) or olfactory sensation scores, despite the PRP group having higher scores (n = 2 RCTs, SMD = 0.53; 95% CI [-0.32, 1.39], p = 0.22).
CONCLUSIONS: This study highlights the potential advantages of using PRP as an additional treatment for individuals with chronic sinusitis undergoing ESS. The improvements associated with PRP include facilitating wound healing, reducing inflammation and enhancing surgical outcomes. To optimise the use of PRP in clinical settings, future research should focus on conducting larger trials with standardised protocols.
摘要：
背景：为了全面评估报道的富血小板血浆（PRP）在接受内窥镜鼻窦手术（ESS）的慢性鼻窦炎患者中的临床有效性。
方法：我们对随机对照试验（RCTs）进行了系统评价和荟萃分析。五个数字在线数据库(PubMed，Scopus,WebofScience,GoogleScholar和CochraneCENTRAL）从成立之初一直搜索到2023年5月1日。我们的具体结果包括通过Lund-Kennedy评分或Meltzer评分测量的术后鼻内镜评分，嗅觉感觉评分和术前嗅觉缺失持续时间。将所有数据汇总为具有95%置信区间(CI)的标准化平均差(SMD)。使用RevMan软件。
结果：本系统综述和荟萃分析包括六个RCT，共有169名患者。纳入的随机对照试验的偏倚风险在三个随机对照试验中很低，一个RCT中存在一些担忧，两个RCT中存在高风险。对术后鼻内镜评分的总体分析表明，PRP组的评分低于对照组（n=3，SMD=-1.19；95%CI[-1.94，-0.44]，p=.002）。PRP和对照组之间在无嗅觉持续时间方面没有显着差异（n=2个随机对照试验，SMD=0.21；95%CI[-0.17，0.59]，p=0.28)或嗅觉评分，尽管PRP组得分较高(n=2个随机对照试验，SMD=0.53；95%CI[-0.32，1.39]，p=0.22）。
结论：这项研究强调了使用PRP作为慢性鼻窦炎患者接受ESS的额外治疗的潜在优势。与PRP相关的改善包括促进伤口愈合，减少炎症和提高手术效果。为了优化PRP在临床环境中的使用，未来的研究应该集中在使用标准化方案进行更大规模的试验.
方法：我们对随机对照试验（RCTs）进行了系统评价和荟萃分析。五个数字在线数据库(PubMed，Scopus,WebofScience,GoogleScholar和CochraneCENTRAL）从成立之初一直搜索到2023年5月1日。我们的具体结果包括通过Lund-Kennedy评分或Meltzer评分测量的术后鼻内镜评分，嗅觉感觉评分和术前嗅觉缺失持续时间。将所有数据汇总为具有95%置信区间(CI)的标准化平均差(SMD)。使用RevMan软件。
结果：本系统综述和荟萃分析包括六个RCT，共有169名患者。纳入的随机对照试验的偏倚风险在三个随机对照试验中很低，一个RCT中存在一些担忧，两个RCT中存在高风险。对术后鼻内镜评分的总体分析表明，PRP组的评分低于对照组（n=3，SMD=-1.19；95%CI[-1.94，-0.44]，p=.002）。PRP和对照组之间在无嗅觉持续时间方面没有显着差异（n=2个随机对照试验，SMD=0.21；95%CI[-0.17，0.59]，p=0.28)或嗅觉评分，尽管PRP组得分较高(n=2个随机对照试验，SMD=0.53；95%CI[-0.32，1.39]，p=0.22）。
结论：这项研究强调了使用PRP作为慢性鼻窦炎患者接受ESS的额外治疗的潜在优势。与PRP相关的改善包括促进伤口愈合，减少炎症和提高手术效果。为了优化PRP在临床环境中的使用，未来的研究应该集中在使用标准化方案进行更大规模的试验.
