摘要
目的评价低温等离子射频消融治疗儿童鼾症的疗效及安全性。方法计算机检索中国知网、维普数据库、万方数据库、Pub Med、EMBASE和Cochrane,查找有关低温等离子射频消融腺样体及扁桃体切除(等离子组)与腺样体刮除及扁桃体剥离(传统组)治疗儿童鼾症疗效及安全性对比的随机对照研究。检索时限为建库至2016年12月。对纳入的文献进行方法学评价,并用Revman5.3软件对纳入研究中的术中及术后指标进行Meta分析。结果共纳入8个随机对照研究,患儿总人数为629例,其中315例患者接受等离子手术;314例患者接受传统手术,即传统组。Meta分析结果显示:与传统组相比,等离子组手术时间明显缩短[MD=-11.61(-15.92,-7.29),P<0.00001];术中出血量显著减少[MD=-52.20(-70.59,-33.82),P<0.00001];患者术后疼痛程度减轻(术后6、24、48、72 h)(VAS评分)(P<0.00001);术后疼痛持续时间缩短[MD=-2.12(-2.98,-1.26),P<0.00001];恢复正常饮食时间缩短[MD=-2.07,95%CI(-3.54,-0.60),P=0.006];手术有效率提高[OR=3.43,95%CI(1.19,9.90),P=0.02];而术后出血率无统计学差异(P=0.33)。结论相比传统手术方式,低温等离子射频消融术治疗儿童鼾症具有创伤小、术后恢复快,更安全、更有效等优势。
Objective To explore the effect and safety of low-temperature plasma radiofrequency ablation in children with snoring disease. Methods The relevant literatures of randomized controlled trials about the effect and safety comparison of eoblation-assisted adenotonsillectomy （coblation group） and cold dissection adenotonsillectomy （conventional group） in children with snoring disease were searched through CNKI, Weipu database, Wanfang database, PubMed, EMBASE and the Cochrane Library. Methodologies were evaluated in all the included studies, and their intraoperative and postoperative parameters were pooled and compared using RevMan 5.3. Results A total of 629 patients in 8 studies fulfilled the study requirement. Of them, 315 patients belonged to the coblation group and 314 belonged to the conventional group. The meta-analysis showed that for the coblation group versus the conventional group, the surgical time was significantly shorter [ MD = - 11.61 （ - 15.92, - 7.29 ）, P 〈 O. 00001 ~, intraoperative blood loss was statistically lower [ MD = -52.20（ -70.59, -33.82）,P 〈 0. 00001 ], reported postoperative pain scores （VAS scoring） were statistically lower（6 h, 24 h, 48 h,72 h after operation）（P 〈 0. 00001 ）, pain duration was shorter [ MD = -2. 12 （ -2.98, - 1.26） ,P 〈 0. 00001], duration for patients returned to normal diet was shorter [ MD = - 2.07, 95% CI（ - 3.54, -0.60）, P = 0. 006 ], and the effective rate was improved [ OR = 3.43,95% CI（ 1.19,9.90 ）, P = 0.02 ]. The analysisshowed statistically insignificant difference in postoperative hemorrhage rate between the two groups （P = 0. 33 ）. Conclusion Compared with conventional method, low-temperature plasma radiofrequency ablation is more effective and safe with minimal invasion and quick recovery for children with snoring disease.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2017年第2期95-99,104,共6页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
湘雅医院-北大未名临床与康复研究基金(xywm2015II10)
关键词
儿童鼾症
低温等离子射频消融
腺样体扁桃体切除
META分析
Children with snoring disease
Low-temperature radiofrequency ablation
Adenotonsillectomy
Meta-analysis
