目的:本荟萃分析的目的是比较早期经鼻泪囊鼻腔吻合术(DCR)和延迟性DCR治疗急性泪囊炎(AD)的结果。
方法:PubMed的全面电子搜索,Embase,WebofScience,和Cochrane图书馆数据库进行到2023年11月11日。使用ReviewManager5.4进行数据合成,并为每个结果测量生成森林地块。使用漏斗图和Egger检验评估潜在的发表偏倚。
结果:共有6项研究纳入了288例患者的荟萃分析。总的来说,早期鼻内DCR的成功率与延迟DCR组相当(比值比[OR]=1.52,95%置信区间[CI]:0.81~2.85,P=.19).此外,与延迟DCR组相比,鼻内动脉早期DCR显著缩短了内侧can肿胀消退时间(平均差异[MD]=-4.92,95%CI:-5.46~4-.37,P<.00001)和症状完全缓解时间(MD=-17.70,95%CI:-23.88~-11.52,P<.00001).
结论:原发性早期鼻内DCR似乎是治疗AD的一种有希望且有利的方法,与常规延迟DCR相比,疗效相当,症状缓解更快。
OBJECTIVE: The aim of this meta-analysis is to compare the outcomes of early endonasal dacryocystorhinostomy (DCR) with delayed DCR in the treatment of acute dacryocystitis (AD).
METHODS: A comprehensive electronic search of PubMed, Embase, Web of Science, and the Cochrane Library databases was conducted up to November 11, 2023. Data synthesis was performed using
Review Manager 5.4, and forest plots were generated for each outcome measure. Potential publication bias was assessed using funnel plots and Egger\'s test.
RESULTS: Six studies involving 288 patients were included in the meta-analysis. Overall, the success rate of early endonasal DCR was comparable to that in the delayed DCR group (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 0.81-2.85, P = .19). Furthermore, in comparison with the delayed DCR group, early endonasal DCR significantly reduced the time for medial canthus swelling resolution (mean differences [MD] = -4.92, 95% CI: -5.46 to 4-.37, P < .00001) and complete resolution of symptoms (MD = -17.70, 95% CI: -23.88 to -11.52, P < .00001).
CONCLUSIONS: Primary early endonasal DCR seems to be a promising and favorable approach for managing AD with comparable efficacy and faster relief of symptoms compared to conventional delayed DCR.