■目前,鼻窦炎伴鼻息肉的手术治疗取得了很大进展,但其复发率仍然很高。因此,这一次,采用Meta分析研究鼻内镜手术治疗儿童慢性鼻窦炎伴鼻息肉的疗效,分析其有效性和安全性,为临床治疗提供理论依据。
■采用布尔逻辑搜索从各种数据库中检索文章,包括PubMed,Medline,和中国国家知识基础设施(CNKI),发布自数据库建立至2021年12月30日。使用了以下搜索词:“内窥镜鼻窦手术”,“前鼻齿息肉”,“慢性鼻窦炎伴鼻息肉”,和“鼻息肉”。还筛选出了传统手术治疗与内窥镜鼻窦手术的比较研究。利用ReviewManager进行荟萃分析。
■本研究共纳入9篇参考文献,大部分为低风险偏倚(中、高质量)。Meta分析显示,对照组与实验组之间无统计学异质性(Chi2=0.03,I2=0%,P=0.98)。根据固定效应模型分析,实验组发生息肉的患者数量明显少于对照组(Z=2.65,P=0.008)。与对照组相比,术后复发无统计学异质性(Chi2=1.59,I2=0%,P=0.45)。根据固定效应模型的分析,实验组术后复发率明显少于对照组(Z=2.92,OR=2.78,95%CI:1.40~5.52,P=0.004)。与对照组相比,术后视觉模拟评分(VAS)结果有统计学差异(Chi2=12.63,I2=84%,P=0.002)。根据随机效应模型分析,实验组VAS评分明显低于对照组(Z=18.06,MD=4.51,95%CI:3.96~5.05,P<0.00001)。
■鼻内镜手术可以减少患者术后复发和疼痛,在儿童慢性鼻窦炎伴鼻息肉的治疗中具有较高的疗效和安全性。
UNASSIGNED: At present, the surgical treatment of sinusitis with nasal polyps has made great progress, but its recurrence rate is still high. Therefore, this time, meta-analysis is used to study the therapeutic effect of endoscopic sinus surgery on children with chronic sinusitis with nasal polyps, analyze its effectiveness and safety, and provide theoretical basis for clinical treatment.
UNASSIGNED: Boolean logic searching was adopted to retrieve articles from various databases, including PubMed, Medline, and Chinese National Knowledge Infrastructure (CNKI), published from the establishment of the database to December 30, 2021. The following search terms were used: \"endoscopic sinus surgery\", \"antrochoanal polyps\", \"chronic sinusitis with nasal polyps\", and \"nasal polyps\". Comparative studies on traditional surgical treatment and endoscopic sinus surgery were also screened out.
Review Manager was utilized for meta-analysis.
UNASSIGNED: A total of 9 references were included in the study, and most of them were low risk bias (medium and high quality). Meta-analysis showed that there was no statistical heterogeneity between the control group and the experimental group (Chi2=0.03, I2=0%, P=0.98). According to the fixed effect model analysis, the number of patients with polyp formation in the experimental group was significantly less than that in the control group (Z=2.65, P=0.008). Compared with the control group, there is no statistical heterogeneity in the postoperative recurrence (Chi2=1.59, I2=0%, P=0.45). According to the analysis of fixed effect model, the postoperative recurrence in the experimental group is significantly less than that in the control group (Z=2.92, OR =2.78, 95% CI: 1.40-5.52, P=0.004). Compared with the control group, the results of postoperative visual analogue scale (VAS) were statistically different (Chi2=12.63, I2=84%, P=0.002). According to the random effect model analysis, the VAS score of the experimental group was significantly lower than that of the control group (Z=18.06, MD =4.51, 95% CI: 3.96-5.05, P<0.00001).
UNASSIGNED: Endoscopic sinus surgery could reduce the postoperative recurrence and pain of patients, and showed high curative effects and safety in the treatment of children with chronic sinusitis with nasal polyps.