泪前隐窝入路与柯陆式入路在上颌窦内翻性乳头状瘤手术疗效的Meta分析  

A meta-analysis of the effect of the anterior lacrimal recess approach and the Caldwell-Luc approach in the surgical treatment of inverted papilloma in the maxillary sinus

作　　者：廖红明 郑志刚[1] 陈绪清[1] 何本超[1] Liao Hongming;Zheng Zhigang;Chen Xuqing;He Benchao(Department of Otorhinolaryngology Head and Neck Surgery,the First People's Hospital of Tianmen in Hubei Province,Tianmen 431700,China)

机构地区：[1]湖北省天门市第一人民医院耳鼻咽喉头颈外科,431700

出　　处：《国际耳鼻咽喉头颈外科杂志》2022年第4期192-198,共7页International Journal of Otolaryngology-Head and Neck Surgery

摘　　要：目的评价泪前隐窝入路与柯陆式入路在上颌窦内翻性乳头状瘤手术疗效的差异。方法计算机检索中国知网、万方数据库、维普全文数据库、Pubmed、Web of Science、Cochrane library等数据库关于经泪前隐窝入路与柯陆式入路在上颌窦内翻性乳头状瘤手术疗效的对照研究。由4名评价员独立筛选、讨论,纳入研究资料后采用Revman5.3软件进行Meta分析。结果经筛选共纳入10项研究694例患者,其中泪前隐窝组348例,柯陆式组346例。Meta分析结果显示:两组患者手术时间[MD=-2.68,95%CI(-8.72~3.37),P=0.39]、术中出血量[MD=-21.28,95%CI(-52.18~9.63),P=0.18]、住院时间[MD=-0.78,95%CI(-1.73~0.17),P=0.11]比较差异均无统计学意义。亚组分析后,单组样本量<20例两组患者手术时间[MD=-8.67,95%CI(-11.67~-5.66),P<0.01]、单组样本量<30例术中出血量[MD=-71.33,95%CI(-81.23~-61.42),P<0.01]、单组样本量<20例住院时间[MD=-2.24,95%CI(-3.32~-1.16),P<0.01],差异均有统计学意义,泪前隐窝组在手术时间、术中出血量及住院时间均优于柯陆式组;泪前隐窝组患者术后并发症发生率低于柯陆式组,差异有统计学意义[OR=0.40,95%CI(0.26~0.62),P<0.01],治愈情况[OR=1.55,95%CI(0.48~2.72),P=0.76]、术后复发[OR=0.89,95%CI(0.59~1.35),P=0.58],差异无统计学意义。结论泪前隐窝入路与柯陆式入路是治疗上颌窦内翻性乳头状瘤的两种手术方式,当前证据显示泪前隐窝入路治疗上颌窦内翻性乳头状瘤的疗效优于柯陆式入路。Objective To evaluate the difference of surgical effects between anterior lacrimal recess approach and Caldwell-Luc approach in the treatment of maxillary sinus inverted papilloma.Methods Computer search of databases such as CNKI,Wanfang database,Weipu full-text database,Pubmed,Web of Science,Cochrane library database,and other databases to search for the curative effect of anterior lacrimal recess approach and Caldwell-Luc approach in inverted papilloma of maxillary sinus Randomized and non-randomized controlled studies.After 4 reviewers independently selected,discussed,and included the research data,the Revman5.3 software was used for meta-analysis.Results A total of 10 studies were included,with a total of 694 patients,including 348 cases in the anterior lacrimal recess group and 346 cases in the Caldwell-Luc group.Meta-analysis results showed that the operation time of the two groups of patients[MD=268,95%CI(-8.72-3.37),P=0.39],intraoperative blood loss[MD=-21.28,95%CI(-52.18-9.63),P=0.18],length of stay[MD=-0.78,95%CI(-1.73-0.17),P=0.11].The difference was not statistically significant.After subgroup analysis,the sample size of a single group was less than 20 cases and the operation time of the two groups of patients[MD=-8.67,95%CI(-11.67--5.66),P<0.01],single group sample size<30 cases of intraoperative blood loss[MD=-71.33,95%CI(-81.23--61.42),P<0.01],single group sample size<20 hospitalization time[MD=2.24,95%CI(-3.32--1.16),P<0.01]the difference was statistically significant,the anterior lacrimal recess approach had a significant difference in operation time and intraoperative bleeding The amount and 1ength of hospital stay were superior to the Caldwell-Luc group;postoperative complications[OR=040,95%CI(0.26-0.62),P<0.01],the difference was statistically significant,cure[OR=1.55,95%CI(0.48-2.72),P=0.76],postoperative recurrence[OR=0.89,95%CI(0.59-1.35),P=0.58],the difference was not statistically significant,postoperative complications occurred in patients with anterior lacrimal recess approach,The rate

关 键 词：乳头状瘤 内翻性 上颌窦 治疗结果 META分析 泪前隐窝入路 柯-陆入路 

分 类 号：R762[医药卫生—耳鼻咽喉科]