鼻内镜下低温等离子与电动吸割器治疗腺样体肥大疗效比较的Meta分析

摘要

目的:评价鼻内镜辅助下低温等离子(endoscopic-assisted low temperature plasma,ELTP)与电动吸割器(electric planer,EP)治疗腺样体肥大疗效的差异.方法:计算机检索中国知网,万方数据库,维普数据库,中国生物医学文献数据库,PubMed,Embase和Cochrane数据库,查找有关ELTP与EP切除腺样体疗效对比的随机对照研究.检索时限为2007年1月至2016年6月.对纳入的文献进行方法学评价,并用Revman 5.2软件对符合标准的研究进行Meta分析.结果:最终纳入13个随机对照研究,共1 448名患者,其中722名患者接受ELTP手术,即ELTP组,726名患者接受EP手术,即EP组.Meta分析结果示:与EP手术相比,ELTP手术的总体有效率明显提高(OR=3.19,95％ CI:1.42～7.15),P=0.005],并且术中出血量明显减少(MD=-20.35,95％ CI:-20.84～-19.87,P＜0.001),手术时间明显缩短(MD=-15.71,95％CI:-18.06～-12.17,P＜0.001),并发症的发生率也明显降低(OR=0.13,95％CI:0.06～0.30,P＜0.001);而两组术中圆枕损伤发生率、术后腺样体残留及术后出血发生率差异无统计学意义.结论:相比于EP,ELTP在腺样体肥大手术中更具有优势.%Objective:To compare the effect of endoscopic-assisted low temperature plasma (ELTP) and electric planer (EP) on the treatment of adenoid hypertrophy.Methods:We searched China National Knowledge Infrastructure (CNKI),Wanfang Database,Weipu Database,Chinese Biomedical Literature (CMB),PubMed,Embase,Cochrane Database,and collected the randomized controlled studies regarding the effect of ELTP and EP on the treatment of adenoid hypertrophy from January 2007 to June 2016.Methodologies were used to evaluate the included studies,and Meta-analysis was performed by Revman 5.2.Results:Thirteen studies including 1 448 patients fulfilled the study requirement.Seven hundred and twenty-two patients were treated with ELTP,and 726 patients were treated with EP.The Meta-analysis showed:compared with EP,ELTP could improve the cure rare (OR=3.19,95％ CI 1.42to 7.15,P=0.005),reduce the blood loss during surgery (MD=-20.35,95％ CI-20.84 to-19.87,P＜0.001),shorten the operation time (MD=-15.71,95％ CI-18.06 to-12.17,P＜0.001),and reduce the incidence of complications (OR=0.13,95％ CI 0.06 to 0.30,P＜0.001),while there was no difference between the 2 groups in the postoperative residual rate of adenoid,postoperative hemorrhage rate and the rate oftorus tubarius injury.Conclusion:Comparing with EP,ELTP shows more advantages in the adenoidectomy.