[1]邱增玉,方 平,汪 东,等.慢性鼻窦炎内镜鼻窦手术中植入全降解鼻窦药物支架有效性及安全性的Meta分析[J].医学信息,2021,34(13):75-80.[doi:10.3969/j.issn.1006-1959.2021.13.019]
 QIU Zeng-yu,FANG Ping,WANG Dong,et al.Meta-analysis of the Effectiveness and Safety of Implantation of Fully Degradable Sinus Drug Stent During Endoscopic Sinus Surgery for Chronic Sinusitis[J].Medical Information,2021,34(13):75-80.[doi:10.3969/j.issn.1006-1959.2021.13.019]
点击复制

慢性鼻窦炎内镜鼻窦手术中植入全降解鼻窦药物支架有效性及安全性的Meta分析()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年13期
页码:
75-80
栏目:
论著
出版日期:
2021-07-01

文章信息/Info

Title:
Meta-analysis of the Effectiveness and Safety of Implantation of Fully Degradable Sinus Drug Stent During Endoscopic Sinus Surgery for Chronic Sinusitis
文章编号:
1006-1959(2021)13-0075-06
作者:
邱增玉方 平汪 东
(安徽医科大学第一附属医院耳鼻咽喉头颈外科,安徽 合肥 230022)
Author(s):
QIU Zeng-yuFANG PingWANG Donget al.
(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Anhui Medical University, Hefei 230022,Anhui,China)
关键词:
鼻窦炎全降解鼻窦药物支架息肉样变
Keywords:
SinusitisFully degradable sinus drug stentPolypoid degeneration
分类号:
R765.9
DOI:
10.3969/j.issn.1006-1959.2021.13.019
文献标志码:
A
摘要:
目的 系统评价慢性鼻窦炎内镜鼻窦手术中植入全降解鼻窦药物支架的有效性及安全性。方法 计算机检索PubMed、EMbase、Cochrane、中国生物医学文献数据库(CBM)、中国知网全文数据库(CNKI)、万方及维普数据库(VIP),检索时间为建库起至2020年11月,纳入有关慢性鼻窦炎内镜鼻窦手术中植入全降解鼻窦药物支架的随机对照试验,经文献筛选、资料提取和质量评价,对符合标准的文献提取相关效应指标,应用Revman 5.4软件进行Meta分析。结果 共纳入7个临床随机对照试验,其中SES组661例,对照组661例。Meta分析显示,SES组术后干预次数少于对照组[RR=0.57,95%CI(0.49,0.66),P<0.05],息肉样变情况[RR=0.46,95%CI(0.36,0.58),P<0.05]、窦口狭窄/闭锁情况[RR=0.55,95%CI(0.43,0.71),P<0.05],炎症VAS评分[RR=-10.78,95%CI(-14.98,-6.57),P<0.05]、瘢痕形成/粘连情况[RR=0.57,95%CI(0.15,0.69),P<0.05]、中鼻甲侧位化情况[RR=0.36,95%CI(0.13,0.97),P<0.05]优于对照组;两组术后眼压比较,差异无统计学意义[MD=-0.21,95%CI(-0.78,0.36),P=0.47]。结论 全降解鼻窦药物支架可有效控制炎症,利于减少窦口狭窄/闭塞、粘连/瘢痕、中鼻甲侧位化情况及术中干预次数,且无明显不良反应,因此在慢性鼻窦炎内镜鼻窦手术中植入全降解鼻窦药物支架是安全、有效、可行的,但其长期疗效及植入时机、植入浓度仍需进一步的临床研究。
Abstract:
Objective To systematically evaluate the effectiveness and safety of implanting a fully degradable sinus drug stent in endoscopic sinus surgery for chronic sinusitis.Methods Computer search of PubMed, EMbase, Cochrane, China Biomedical Literature Database (CBM), China National Knowledge Base (CNKI), Wanfang and VIP Database (VIP),The retrieval time is from the establishment of the database to November 2020. Randomized controlled trials involving the implantation of fully degradable sinus drug stents in endoscopic sinus surgery for chronic sinusitis were included.After literature screening, data extraction and quality evaluation, the relevant effect indicators of the literature that meet the standards were extracted, and the Revman 5.4 software was used for Meta analysis.Results A total of 7 clinical randomized controlled trials were included, including 661 cases in the SES group and 661 cases in the control group. Meta analysis showed that the number of postoperative interventions in the SES group was less than that in the control group [RR=0.57, 95%CI (0.49, 0.66), P<0.05],polypoid changes [RR=0.46, 95%CI (0.36, 0.58),P<0.05],sinus ostium stenosis/atresia [RR=0.55, 95%CI(0.43,0.71), P<0.05],inflammation VAS score [RR=-10.78, 95%CI(-14.98, -6.57), P<0.05],scar formation/adhesion [RR=0.57, 95%CI (0.15, 0.69), P<0.05],The lateralization of the middle turbinate [RR=0.36, 95%CI (0.13, 0.97), P<0.05] was better than that of the control group; there was no statistically significant difference between the two groups in postoperative intraocular pressure [MD=-0.21, 95% CI(-0.78, 0.36), P=0.47].Conclusion The fully degradable sinus drug stent can effectively control inflammation, help reduce sinus stenosis/occlusion, reduce adhesions/scars, postoperative intervention, lateralization of the middle turbinate, and no obvious adverse reactions.Therefore, it is safe, effective and feasible to implant a fully degradable sinus drug stent in endoscopic sinus surgery for chronic sinusitis, but its long-term efficacy, implant timing and implant concentration still need further clinical research.

参考文献/References:

[1]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.中国慢性鼻窦炎诊断和治疗指南(2018)[J].中华耳鼻咽喉头颈外科杂志,2019,54(2):81-100. [2]张丽川,孙敬武,李希平,等.内镜鼻窦手术对慢性鼻-鼻窦炎伴鼻息肉患者嗅觉功能转归的影响[J].临床耳鼻咽喉头颈外科杂志,2019,33(8):713-717. [3]万玉峰,刘龙生,徐盼盼,等.慢性鼻窦炎内镜术中使用可吸收鼻窦药物支架的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2020,34(5):417-420. [4]Taulu R,Sillanpaa N,Numminen J,et al.Ethmoidal drug-eluting stent therapy is not superior to nasal corticosteroid spray in the prevention of endoscopic sinus surgery: Results from a randomised, clinical trial[J].Clin Otolaryngol,2020,45(3):402-408. [5]Huang Z,Zhou B,Wang D,et al.Comparison of Bioabsorbable Steroid-Eluting Sinus Stents Versus Nasopore After Endoscopic Sinus Surgery: A Multicenter, Randomized, Controlled, Single-Blinded Clinical Trial[J].Ear Nose Throat J,2020:145561320947632. [6]Murr AH,Smith TL,Hwang PH,et al.Safety and efficacy of a novel bioabsorbable, steroid-eluting sinus stent[J].Int Forum Allergy Rhinol,2011,1(1):23-32. [7]Marple BF,Smith TL,Han JK,et al.Advance II: a prospective, randomized study assessing safety and efficacy of bioabsorbable steroid-releasing sinus implants[J].Otolaryngol Head Neck Surg,2012,146(6):1004-1011. [8]Smith TL,Singh A,Luong A,et al.Randomized controlled trial of a bioabsorbable steroid-releasing implant in the frontal sinus opening[J].Laryngoscope,2016,126(12):2659-2664. [9]Luong A,Ow RA,Singh A,et al.Safety and Effectiveness of a Bioabsorbable Steroid-Releasing Implant for the Paranasal Sinus Ostia: A Randomized Clinical Trial[J].JAMA Otolaryngol Head Neck Surg,2018,144(1):28-35. [10]Adriaensen GFJPM,Lim KH,Fokkens WJ.Safety and efficacy of a bioabsorbable fluticasone propionate-eluting sinus dressing in postoperative management of endoscopic sinus surgery: a randomized clinical trial[J].Int Forum Allergy Rhinol,2017,7(8):813-820. [11]Singh A,Luong AU,Fong KJ,et al.Bioabsorbable steroid-releasing implants in the frontal sinus ostia: a pooled analysis[J].Int Forum Allergy Rhinol,2019,9(2):131-139. [12]Dai Q,Duan C,Liu Q,et al.Effect of nebulized budesonide on decreasing the recurrence of allergic fungal rhinosinusitis[J].Am J Otolaryngol,2017,38(3):321-324. [13]Akiyama K,Makihara S,Uraguchi K,et al.Impact of Preoperative Systemic Corticosteroids on the Histology and Diagnosis of Eosinophilic Chronic Rhinosinusitis[J].Int Arch Allergy Immunol,2019,179(2):81-88. [14]倪祎华,许政敏.鼻窦球囊扩张结合全降解药物支架治疗儿童慢性鼻窦炎的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2020,34(6):481-485,491. [15]Kern RC,Stolovitzky JP,Silvers SL,et al.A phase 3 trial of mometasone furoate sinus implants for chronic sinusitis with recurrent nasal polyps[J].Int Forum Allergy Rhinol,2018,8(4):471-481. [16]Forwith KD,Han JK,Stolovitzky JP,et al.RESOLVE: bioabsorbable steroid-eluting sinus implants for in-office treatment of recurrent sinonasal polyposis after sinus surgery: 6-month outcomes from a randomized, controlled, blinded study[J].Int Forum Allergy Rhinol,2016,6(6):573-581. [17]Huang Z,Huang Q,Zhou B,et al.Bioabsorbable steroid-eluting sinus stents for patients with refractory frontal diseases undergoing a revision Draf 3 procedure: a case series[J].Acta Otolaryngol,2019,139(7):636-642. [18]Matheny KE.Bioabsorbable steroid-releasing sinus implants in the frontal and maxillary sinuses: 2-year follow-up[J].Allergy Rhinol (Providence),2015,6(2):118-121. [19]孙桂丽,王夏,赵倩.短期局部应用糖皮质激素致儿童高眼压10例临床分析[J].中国实用医药,2016,11(3):163-164.

相似文献/References:

[1]李晓伟,鞠 林,李俊宽,等.鼻窦炎术后下肢静脉血栓形成1例[J].医学信息,2018,31(08):192.[doi:10.3969/j.issn.1006-1959.2018.08.072]
[2]张淑华,闫 丽,郑鹏举.心理护理对鼻窦炎患者心理波动的影响研究[J].医学信息,2018,31(11):172.[doi:10.3969/j.issn.1006-1959.2018.11.057]
 ZHANG Shu-hua,YAN Li,ZHENG Peng-ju.The Effect of Psychological Nursing on Psychological Fluctuations in Patients with Sinusitis[J].Medical Information,2018,31(13):172.[doi:10.3969/j.issn.1006-1959.2018.11.057]
[3]麦颖达,许卫华,李 峰,等.慢性鼻窦炎伴鼻息肉炎症因子的研究[J].医学信息,2020,33(04):40.[doi:10.3969/j.issn.1006-1959.2020.04.013]
 MAI Ying-da,XU Wei-hua,LI Feng,et al.Study on Inflammatory Factors of Chronic Rhinosinusitis with Nasal Polyps[J].Medical Information,2020,33(13):40.[doi:10.3969/j.issn.1006-1959.2020.04.013]

更新日期/Last Update: 1900-01-01