我国低温等离子消融术与常规扁桃体剥离术临床疗效的Meta分析

左红霞; 牛玉明; 张超; 黄健健; 汪龙; 杜士明

doi:10.13201/j.issn.1001-1781.2018.04.007

我国低温等离子消融术与常规扁桃体剥离术临床疗效的Meta分析

- 1. 十堰市太和医院(湖北医药学院附属医院)循证医学中心(湖北十堰, 442000);
- 2. 十堰市太和医院(湖北医药学院附属医院)耳鼻咽喉头颈外科;
- 3. 十堰市太和医院(湖北医药学院附属医院)科研处

详细信息

通讯作者: 杜士明,E-mail:dsmch@sina.com

中图分类号: R767.91

收稿日期: 2017-09-19

The clinical efficacy of coblation tonsillectomy and conventional tonsillectomy in China:A Meta analysis

- 1. Department of Evidence-Based Medicine and Clinical Research, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan, 442000, China;
- 2. Department of Otorhinolaryngology Head and Neck Surgery, Taihe Hospital Affiliated to Hubei University of Medicine;
- 3. Department of Scientific Research, Taihe Hospital Affiliated to Hubei University of Medicine

More Information

Corresponding author: DU Shiming, E-mail: dsmch@sina.com

Received Date: 19 September 2017

摘要

摘要: 目的：系统评价我国低温等离子消融术与常规扁桃体剥离术对扁桃体切除临床疗效的影响。方法：计算机检索PubMed、Cumulative Index to Nursing and Allied Health （CINAHL）、EMBASE、Cochrane Library （2017年4期）、CBM、CNKI、VIP、WanFang数据库、SUMsearch和Google搜索引擎，查找自建库以来至2017年4月30日国内关于低温等离子消融术与常规扁桃体剥离术的随机对照试验（RCT）。由2位评价员独立筛选文献及提取资料，用Cochrane Handbook for Systematic Review of Interventions Version 5.1.0[updated March 2011]手册中针对RCT的偏倚风险评估工具进行评价后，采用Cochrane协作网提供的RevMan 5.3软件进行Meta分析。结果：共纳入32个研究，包含3 197例行扁桃体切除术患者。Meta分析结果显示：低温等离子组患者扁桃体手术切除时间[MD=-17.03，95%CI（-19.78，-14.28），P<0.00001]、术中平均出血量[MD=-27.00，95%CI（-30.44，-23.56），P<0.00001]、术后24 h疼痛[MD=-2.00，95%CI（-2.65，-1.35），P<0.00001]、术后恢复正常饮食时间[MD=-2.01，95%CI（-2.60，-1.42），P<0.00001]、白膜形成时间[MD=-2.44，95%CI（-3.96，-0.93），P=0.002]均明显小于常规剥离组；而术后白膜脱落时间[MD=2.02，95%CI（0.65，3.39），P=0.004]明显长于常规剥离组。结论：与常规剥离术相比，低温等离子切除扁桃体可明显缩短手术时间，减少术中出血量，减轻术后24 h疼痛程度，术后较早恢复正常饮食，且白膜形成时间较早，但延迟脱落。鉴于受纳人研究文献文种和质量有限，上述结论尚需展开更多大样本、高质量的RCT予以验证。
- 低温等离子消融术 /
- 常规扁桃体剥离术 /
- 随机对照试验 /
- Meta分析
Abstract: Objective: To systematically review the clinical efficacy of coblation tonsillectomy and conventional tonsillectomy in China.Method: Randomized controlled trials (RCT) of coblation tonsillectomy and conventional tonsillectomy were searched and retrieved through online databases (PubMed, Cumulative Index to Nursing and Allied Health, EMBASE, Cochrane Library, CBM, CNKI, VIP, WanFang, SUMsearch and Google search engine) and related literatures were reviewed up to 30 April, 2017. Two investigators independently screened literatures,extracted data and evaluated the risk of bias assessment tools for RCT using the Version 5.1.0 of Cochrane Handbook for Systematic Reviews of Interventions. Then, Meta analysis was performed using RevMan 5.3 software provided by the Cochrane Collaboration.Result: A total of 32 RCTs involving 3 197 tonsillectomy patients were included. The results of meta-analysis showed that:the operation time (MD=-17.03, 95%CI -19.78 to -14.28, P<0.00001), intraoperative blood loss (MD=-27.00, 95%CI -30.44 to -23.56, P<0.00001), postoperative pain in 24 hours (MD=-2.00, 95%CI -2.65 to -1.35, P<0.00001), time needed to regain the normal diet (MD=-2.01, 95%CI -2.60 to -1.42, P<0.00001), formation time of white membrane (MD=-2.44, 95%CI -3.96 to -0.93, P=0.002) of patients in the coblation tonsillectomy group were all significantly lower than the conventional tonsillectomy group; while the exfoliation time of white membrane (MD=2.02, 95%CI 0.65 to 3.39, P=0.004) in the coblation tonsillectomy group was significantly longer than the conventional tonsillectomy group.Conclusion: Current evidence shows that, compared with the conventional tonsillectomy group, the coblation tonsillectomy group can significantly shorten the operation time, decrease intraoperative blood loss, alleviate postoperative pain degree during 24 hours, regain the normal diet early and form white membrane early, but delaye the exfoliation time of white membrane. Due to the limited kinds of literature and quality of the included studies, the above conclusions still need to be verified by carrying out more large scale samples and high quality randomized controlled trials (RCTs) studies.
- coblation tonsillectomy /
- conventional tonsillectomy /
- randomized controlled trials /
- Meta analysis

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