局部使用曲安奈德联合常规介入方法治疗良性中央气道狭窄疗效及安全性的Meta分析  

Efficacy and safety of local triamcinolone combined with conventional interventional therapy in treatment of benign airway stenosis:a meta-analysis

作　　者：何杰 余觅[1,2] 李小燕 张维 孙建[1,2] HE Jie;YU Mi;LI Xiaoyan;ZHANG Wei;SUN Jian(Clinical Medical College of Chengdu Medical College,Chengdu,Sichuan 610500,P.R.China;Department of Respiratory and Critical Care Medicine,First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan 610500,P.R.China)

机构地区：[1]成都医学院临床医学院,四川成都610500 [2]成都医学院第一附属医院呼吸与危重症医学科,四川成都610500

出　　处：《中国呼吸与危重监护杂志》2021年第10期726-733,共8页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的系统评价纤支镜下局部使用曲安奈德联合常规介入方法治疗良性气道狭窄的疗效及安全性。方法根据中英文检索词计算机全面检索PubMed、Cochrane Library、EMbase、Web of science、万方、维普、中国知网,检索时限设置为建库至2019年8月,收集所有关于纤支镜下局部使用曲安奈德联合常规介入方法治疗良性气道狭窄的随机对照试验。2位研究者独立筛选文献,并逐一对文献进行数据提取及方法学质量评价,结合Stata及Revman5.2软件进行Meta分析。结果共纳入9篇随机对照试验文献,总共包括449例气道狭窄患者。Meta分析结果显示:在短期疗效比较中,治疗组患者治疗后的气促评分(SMD=–0.16,95%CI–0.45~0.13,P=0.27)、气道直径(SMD=0.14,95%CI–0.13~0.41,P=0.30)、横截面狭窄率(SMD=–0.01,95%CI–0.36~0.34,P=0.96)与对照组差异均无统计学意义;在长期疗效比较中,治疗组患者治疗后的气促评分(SMD=–2.53,95%CI–3.78~–1.28,P<0.05)、气道直径(SMD=1.31,95%CI 0.83~1.78,P<0.05)、横截面狭窄率(SMD=2.58,95%CI 2.11~3.08,P<0.05)、FEV1(SMD=0.42,95%CI 0.13~0.70,P=0.004)均优于对照组;而在不良反应方面,两组气道内出血的发生率相似(RR=2.00,95%CI 0.88~4.52,P=0.10),其余不良反应如血糖和血浆皮质醇水平紊乱均较轻,对症处理后缓解。结论纤支镜下局部使用曲安奈德联合常规介入方法治疗良性气道狭窄具有较好的长期临床疗效,且不良反应少,患者总体耐受较好,具有一定的临床应用价值。Objective To evaluate the efficacy and safety of local triamcinolone combined with conventional interventional therapy in the treatment of benign airway stenosis.Methods PubMed,Cochrane Library,EMbase,Web of science,wanfang,VIP and China National Knowledge Infrastructure were searched by computer between the establishment of the database and August,2019,and all literatures on the local treatment of benign airway stenosis using triamcinolone combined with conventional interventional therapy were searched.According to inclusion and exclusion criteria,2 researchers screened the literatures and performed the data extraction and methodological quality evaluation.Meta-analysis was performed with Revman5.2 and Stata software.Results In total,nine randomized controlled trials were included in this meta-analysis,including 449 patients with airway stenosis.The total result showed that in the comparison of short-term efficacy,there were no statistically significant differences in breathability score(SMD=–0.16,95%CI–0.45-0.13,P=0.27),airway diameter(SMD=0.14,95%CI–0.13-0.41,P=0.30),and cross-sectional stenosis rate(SMD=–0.01,95%CI–0.36-0.34,P=0.96)between the treatment group and the control group.In the comparison of long-term efficacy,the breathability score(SMD=–2.53,95%CI–3.78-–1.28,P<0.05),airway diameter(SMD=1.31,95%CI 0.83-1.78,P<0.05),cross-sectional stenosis rate(SMD=2.58,95%CI:2.11~3.08,P<0.05),and FEV1(SMD=0.42,95%CI 0.13-0.70,P=0.004)of patients in the treatment group were all better than those in the control group.But in terms of adverse reactions,the incidence of bleeding in the airway between two groups was similar(RR=2.00,95%CI 0.88-4.52,P=0.10),other adverse reactions such as blood glucose and plasma cortisol levels were mild,which can be relieved symptomatically.Conclusion Current evidence suggests that topical triamcinolone combined with conventional interventional therapy for benign airway stenosis has a better long-term clinical efficacy with fewer adverse reactions and better overall pati

关 键 词：曲安奈德 局部注射 局部喷洒 良性气道狭窄 META分析 

分 类 号：R562[医药卫生—呼吸系统]