在慢性鼻炎的内镜鼻手术后术后口服皮质类固醇的使用:系统性审查和元分析

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Justina Shafik¹, Kara Sangiuolo¹, Eden Sheinin¹

¹Otolaryngology Head & Neck Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.

American journal of rhinology & allergy

|April 24, 2025

概括

手术后的口服皮质类固醇 (OCS) 没有显著改善内镜鼻手术 (ESS) 后慢性鼻炎 (CRS) 患者的结局. 然而,OCS在过敏性真菌鼻炎亚型中表现有前途,需要进一步研究.

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.
基于证据的医学是基于证据的医学.

背景情况:

慢性鼻炎 (CRS) 通常需要内镜外科手术 (ESS),当医疗管理失败时.
口服皮质类固醇 (OCS) 在CRS治疗中通常用于ESS后,但它们的有效性缺乏可靠的证据.

研究的目的:

系统地评估术后口服皮质类固醇 (OCSs) 的疗效,对因慢性鼻炎 (CRS) 进行内镜鼻手术 (ESS) 的患者.

主要方法:

一项系统的文献搜索确定了有关OCS在CRS后ESS使用的相关研究.
对鼻结局测试 (SNOT),隆德-肯尼迪 (LK) 内镜和视觉模拟尺度 (VAS) 的得分进行了元分析.
包括的研究分析了OCS类型,剂量和持续时间,重点是随机对照试验.

主要成果:

对14项随机对照试验 (793名患者) 的元分析显示,OCS和非OCS组之间的SNOT,LK或VAS得分没有显著差异.
两项研究表明,使用OCS显著改善了结果,特别是在CRS的过敏真菌鼻炎 (AFRS) 亚型中.
在AFRS中,OCS与伊特拉可纳的比较显示,这两组都出现了改善,但两组之间没有统计学上显著的差异.

结论:

术后的OCS使用没有显示出基于SNOT,LK和VAS得分的ESS接受的整体CRS患者的显著益处.
对过敏性真菌鼻炎 (AFRS) 亚型可能存在OCS的潜在益处,需要进一步调查.
需要进行额外的研究,以确定关于在ESS之后对CRS的OCS使用的最终建议.

关键词:

过敏性真菌鼻炎的发生慢性犀牛鼻炎慢性鼻炎使用皮质类固醇使用.内镜内腔外科手术是指内镜外科手术.慢性鼻炎的医学治疗这是一个元分析.鼻腔多重构成鼻腔多重构成在术后的术后治疗.类固醇治疗类固醇治疗系统性审查系统性审查

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