在术后功能性内镜鼻手术患者中评估鼻水的疗效:系统性审查和元分析
Sridevi Gnanasekaran1, Vinothini Jayaraj1, Yazhini V B2
1Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), (Community Medicine), Room No: 233, Academic Block, Gorakhpur, Uttar Pradesh, 273008, India.
概括
手术后用超出正常盐水的溶液灌鼻子,可显著改善慢性鼻炎患者的症状. 布索尼德表现特别有前途,尽管由于研究变异,需要更多的研究.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 鼻科 鼻科是指鼻科的专家.
- 手术结果研究研究.
背景情况:
- 慢性鼻炎与鼻多重症 (CRSwNP) 通常需要功能性内镜鼻手术 (FESS).
- 手术后用正常盐水灌鼻子是标准护理建议.
- 在FESS之后,不同鼻灌液的比较疗效仍然是需要研究的领域.
研究的目的:
- 系统地审查和元分析FESS后使用的各种鼻灌解决方案的有效性.
- 在CRSwNP患者中,比较非盐溶液与正常盐溶液的结果.
主要方法:
- 在随机对照试验中,按照PRISMA指南进行了系统审查.
- 来自14项研究的数据使用随机效应模型元分析 (R软件) 来合成.
- 关键的结果措施包括Sino-Nasal Outcome Test-22 (SNOT-22) 和Lund-Kennedy鼻腔内镜评分 (LKES);使用Cochrane工具进行偏差评估.
主要成果:
- 与正常盐水相比,各种灌溶液显示出显著的症状和内镜评分减少.
- 观察到改善的趋势 (症状SMD-0.69,内镜得分-0.48),虽然没有统计学意义 (p>0.05).
- 亚组分析表明,布德索尼德可能比正常盐水更有效,但发现了显著的异质性和潜在的出版偏差.
结论:
- 用正常盐水以外的溶液灌鼻腔可以改善患者报告的症状和FESS后的内镜结果.
- 含有Budesonide的灌方法显示了增强有效性的潜力.
- 高异质性和潜在的出版偏见需要谨慎的解释和进一步的高质量研究,标准化结果.
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