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对于良性喉狭窄症的微创内镜干预的局部辅助:一个元分析
Wei Ming1, Jingjing Zuo2, Jibo Han2
1Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China. mw_mingwei@163.com.
概括
当局类固醇注射和吸入类固醇可显著降低与内镜治疗一起使用良性喉狭窄症的复发率. 这些辅助疗法是安全有效的,尽管需要更多的研究才能得出明确的结论.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 最少侵入性的手术
- 医学研究 医学研究
背景情况:
- 良性喉狭窄症通常通过内镜干预来治疗.
- 内镜治疗通常具有很高的复发率.
- 探索局部辅助措施,如类固醇注射,吸入类固醇和米托米辛C,以提高成功率.
研究的目的:
- 为了比较带有和没有局部附加剂的内镜治疗对良性喉狭窄症的疗效.
- 分析与这些治疗相关的临床结果,复发率和并发症.
主要方法:
- 进行了一项元分析,搜索了PubMed,EMBASE,OVID和科学网.
- 包括比较辅助疗法与非辅助疗法在喉狭窄症患者的研究.
- 随机效应模型被用于评估聚合风险估计,不包括评论,案例报告和摘要.
主要成果:
- 包括8项研究 (1204例),分析了内溶性类固醇注射,吸入类固醇和局部菌素C.
- 用类固醇注射或吸入类固醇进行内镜治疗显示复发率降低 (P < 0.05).
- 辅助疗法在特定子组 (前队列,小结节,轻度狭窄) 中显示出较低的复发风险估计. 没有观察到并发症发生率的显著差异.
结论:
- 局部类固醇应用与最少的侵入性干预似乎可以减少喉狭的复发.
- 类固醇和mitomycin C作为辅助剂是安全的,并发症率低.
- 需要高质量的多中心随机对照试验,并进行长期随访,以充分评估疗效和成本效益.
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