目的:本荟萃分析的目的是比较内镜下泪囊鼻腔造口术(Endo-DCR)治疗慢性泪囊炎(CD)的手术效果,术中有无透明质酸(HA)的应用。
方法:使用PubMed进行了电子文献检索,Embase,科克伦图书馆,CNKI,和万方数据库于2022年4月1日。使用ReviewManager软件版本5.4进行数据合成,并为每个结果测量生成森林图。
结果:七项随机对照试验(RCT),涉及739只眼睛,纳入本荟萃分析。总的来说,与对照组相比,术中HA应用显着提高成功率(比值比[OR]=3.27,95%置信区间[CI]:2.15-4.98,P<.00001),促进上皮再形成(OR=2.93,95%CI:1.83-4.68,P<.00001),减少颗粒(OR=0.41,95%CI:0.21-0.80,P=.008),Endo-DCR后形成瘢痕(OR=0.39,95%CI:0.22-0.68,P=.001)。
结论:术中应用HA似乎是一种有用的佐剂,可以通过促进上皮再形成,并在口周围形成肉芽和疤痕来提高成功率。
OBJECTIVE: The aim of this meta-analysis is to compare the surgical results of endoscopic dacryocystorhinostomy (Endo-DCR) for chronic dacryocystitis (CD) with and without intraoperative hyaluronic acid (HA) application.
METHODS: An electronic literature search was performed using the PubMed, Embase, Cochrane Library, CNKI, and Wan Fang databases in April 1, 2022. Review Manager software version 5.4 was used for data synthesis and a forest plot was generated for each outcome measure.
RESULTS: Seven randomized control trials (RCTs), which involved 739 eyes, were included in this meta-analysis. Overall, compared with the control group, intraoperative HA application significantly enhance the success rate (odds ratio [OR] = 3.27, 95% confidence interval [CI]: 2.15-4.98, P < .00001), promote re-epithelization (OR = 2.93, 95% CI: 1.83-4.68, P < .00001), reduce granulation (OR = 0.41, 95% CI: 0.21-0.80, P = .008), and scar (OR = 0.39, 95% CI: 0.22-0.68, P = .001) formation after Endo-DCR.
CONCLUSIONS: Intraoperative HA application seems to be a useful adjuvant that could enhance success rate by promoting re-epithelization and inhabiting granulation and scar formation around the ostium.