预防性抗生素是否有效预防高风险牙提取后的骨质放射性死?
1Department of Oral and Maxillofacial Surgery, College of Dentistry, Mosul University, Mosul, Iraq. omerwaleedmajid@uomosul.edu.iq.
Evidence-based dentistry
|September 23, 2024
概括
高压氧 (HBO),氧菲林-托科菲罗尔 (PENTO) 和抗生素 (ABX) 在头癌患者的牙拔除后显著降低了骨质放射缩 (ORN) 的发生率. 由于成本效益,建议使用抗生素.
科学领域:
- 在瘤学瘤学.
- 在口腔外科手术.
- 辐射疗法 辐射疗法
背景情况:
- 骨质放射性瘤 (ORN) 是头癌的放射治疗后的一种严重并发症.
- 照射患者的牙提取具有ORN的高风险.
- 有效的预防策略对于这种患者群体至关重要.
研究的目的:
- 在放射治疗后的患者中,系统地审查和比较用于预防ORN的辅助治疗方法.
- 评估高压氧气,氧菲林-托科菲罗尔和抗生素的有效性.
主要方法:
- 对RCT和观察性研究进行系统审查和元分析.
- 在PubMed,Embase,Cochrane,Scopus和科学网上进行了搜索.
- 使用ROBINS-I和ROB 2工具评估偏差风险.
- 进行了单臂和双臂的元分析.
主要成果:
- 包括29项研究,涉及1520名患者.
- 与对照组 (17.6%) 相比,高压氧 (4.6%),西菲林-托科菲罗尔 (3.4%) 和抗生素 (3.8%) 的ORN患病率明显较低.
- 高压氧显示ORN的几率低于对照药和抗生素,但不具有统计学意义.
结论:
- 高压氧气,氧菲林-托科菲罗尔和抗生素显示ORN率的可比降低.
- 由于成本效益和可访问性,建议抗生素是最实用的预防方案.
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