鼻内镜辅助下腺样体切除术与传统腺样体刮除术对腺样体增生治疗效果比较的Meta分析  

Comparison the effect of endoscopic-assisted transoral adenoidectomy and traditional transoral curette adenoidectomy on the treatment of adenoid hypertrophy: a meta-analysis

作　　者：顾健伟 邰隽[2] 郭永丽[3] 黄育北[4] 刘悄吟[5] 张晓絮 李晓丹[2] 韩阳[2] 王棽[2] 倪鑫[2] 

机构地区：[1]北京同仁堂中医医院,北京100051 [2]首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,儿童耳鼻咽喉头颈外科疾病北京市重点实验室,北京100045 [3]首都医科大学附属北京儿童医院,北京市儿科研究所,儿童耳鼻咽喉头颈外科疾病北京市重点实验室,北京100045 [4]天津医科大学肿瘤医院肿瘤研究所流行病室,天津300060 [5]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730

出　　处：《中国耳鼻咽喉头颈外科》2014年第9期465-472,共8页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家自然科学基金(81342002);北京市科技计划课题(Z131100006813044)联合资助

摘　　要：目的评价鼻内镜辅助下腺样体切除术(endoscopic-assisted transoral adenoidectomy,ETA)与传统腺样体刮除术(traditional transoral curette adenoidectomy,TCA)对腺样体增生治疗效果的差异。方法系统检索国内外发表的相关研究,采用随机效应模型来合并研究结果。结果共有37篇研究纳入分析,其中ETA治疗患者4169例,TCA治疗患者2494例。Meta分析结果表明,ETA对腺样体增生治疗的总体有效率是TCA的1.14倍(95%CI:1.09-1.19)。除耳闷/耳鸣等症状缓解率没有明显差异,ETA相对TCA分别能使打鼾及鼻塞/鼻漏症状的缓解率提高1.07倍(95%CI:1.02-1.14)和1.23倍(95%CI:1.11-1.37)。同时,两种术式术后出血率没有明显差异,但ETA术后腺样体残留率显著降低为TCA的20%(95%CI:12-33%)。结论ETA相对TCA能够明显提高对腺样体增生治疗的总体有效率,尤其体现在显著降低术后腺样体残留率。OBJECTIVE To compare the effect of endoscopic-assisted transoral adenoidectomy（ETA） and traditional transoral curette adenoidectomy（TCA） on the treatment of adenoid hypertrophy. METHODS Published studies were searched, and pooled relative risk（RR） value and 95%CI were calculated with random-effects model. RESULTS A total of 37 studies were included in the final analysis, including 4169 patients treated with ETA, and 2494 patients with TCA. The cure rate of the ETA was 1.14 times compared with that of the TCA（95%CI： 1.09-1.19）. There was no significant difference for the cure rates of ear stuffy/tinnitus between the two operations. But the cure rates of snoring and nasal congestion/rhinorrhea for ETA were 1.07 times（95%CI： 1.02-1.14） and 1.23 times（95%CI： 1.11-1.37） higher than that for TCA. No significant difference of postoperative hemorrhage rate was found between the two operations. The postoperative residual rate of adenoid for ETA was 20%（95%CI： 12-33%） of that for TCA. CONCLUSION ETA can improve the cure rate compared to TCA, especially the postoperative residual rate.

关 键 词：腺样体切除术 内窥镜检查 META分析 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]