■先天性鼻梨状孔狭窄(CNPAS)是一种罕见的疾病,可导致新生儿呼吸困难。本系统评价的目的是比较钻孔与扩张技术治疗CNPAS的手术效果。
■已发布,Embase,和Cochrane临床试验数据库在2010年至2021年间搜索术语“先天性鼻梨状孔狭窄”或“梨状孔狭窄”。纳入了25项研究,评估了接受CNPAS手术治疗的儿科患者,其结果数据包括并发症,修订,和逗留时间的长短。
■共51例CNPAS患者纳入纳入研究。中位年龄为29天,56.9%为女性,54.9%是足月出生。术前梨形孔宽度中位数为5.00mm(IQR=4.10,6.45)。40名(78.4%)患者接受了唇下钻孔,当6人使用Hegar宫颈扩张器进行扩张手术时,2有一个气球扩张,还有3个是用丙烯酸装置扩张的,气管导管,或者Bougie.76.5%的患者无术后并发症,而9例(17.6%)患者需要第二次手术。中位住院时间为11天(IQR=4,26)。在并发症方面,阴唇下钻孔和手术扩张技术之间没有观察到统计学上的显着差异。需要翻修手术,或逗留时间。
■当前文献不足以确定钻孔或扩张在CNPAS的治疗中是否更有效。
UNASSIGNED: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare condition that results in neonatal respiratory difficulty. The purpose of this systematic review was to compare surgical outcomes of drilling versus dilation techniques in the treatment of CNPAS.
UNASSIGNED: Pubmed, Embase, and Cochrane Clinical Trials databases were searched for terms \"congenital nasal pyriform aperture stenosis\" or \"pyriform aperture stenosis\" from 2010 to 2021. Twenty-five studies were included that evaluated pediatric patients treated surgically for CNPAS with available outcomes data including complications, revisions, and length of stay.
UNASSIGNED: A total of 51 patients with CNPAS were pooled from included studies. The median age was 29 days, 56.9% were female, and 54.9% were born full-term. The median pyriform aperture width before surgery was 5.00 mm (IQR = 4.10, 6.45). Forty (78.4%) patients underwent sublabial drilling, while 6 had a dilation procedure performed with hegar cervical dilators, 2 had a balloon dilation, and 3 were dilated with either an acrylic device, endotracheal tube, or bougie. There were no post-operative complications for 76.5% of patients, while a second surgery was required in 9 (17.6%) patients. The median length of stay was 11 days (IQR = 4, 26). No statistically significant difference was observed between sublabial drilling and surgical dilation techniques with respect to complications, need for revision surgery, or length of stay.
UNASSIGNED: Current literature is insufficient to determine if drilling or dilation is more effective in the treatment of CNPAS.