在鼻手术中晚年:慢性鼻炎的症状增加减少,但手术持久性提高
Ahmad A Mirza1,2,3, Hussam A Senan4, Juan C Hernaiz-Leonardo5
1Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
概括
患有慢性鼻炎 (CRS) 的老年人可能在内镜外科手术 (ESS) 后出现较少的症状缓解,但复发和修复率较低. 年龄不应该成为ESS的障碍,ESS可以被定制为有效的结果.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 外科手术的结果
- 老年医学 老年医学
背景情况:
- 慢性鼻炎 (CRS) 显著影响生活质量.
- 内镜外科手术 (ESS) 是一种常见的CRS治疗方法.
- 在老年患者中ESS的疗效需要进一步研究.
研究的目的:
- 为了比较ESS后晚年患者的症状改善和疾病控制,与CRS的年轻患者进行比较.
- 确定影响不同年龄组ESS结果的因素.
主要方法:
- 在主要数据库 (PubMed,Embase,科学网,Scopus,CENTRAL) 进行系统的文献搜索.
- 包括与年龄分层队列进行的比较研究,报告了经过ESS的CRS患者,遵循PRISMA指南.
- 主要结局:症状改善 (22项鼻结局测试-SNOT-22). 二次结果:疾病复发率和修订率. 进行了元回归分析.
主要成果:
- 对3161名患者的数据分析显示,与年轻人相比,老年患者的SNOT-22改善显著减少 (SMD -0.36,P=.01).
- 高龄患者的复发率 (12%) 和修订率 (3%) 较低,综合风险降低了50% (RR0.50,P<.001).
- 超回归表明男性性别预测症状改善更大 (β=0.06,P=.03),而之前的ESS与老年人的改善减少有关 (β=-0.05,P<.01).
结论:
- 高龄患者可能获得较少的症状缓解,但受益于ESS后的复发和修订率降低.
- 老年人的结局可能会受到并发症和重新手术门的影响,而不仅仅是年龄.
- 当个性化时,ESS仍然是老年人CRS的可行和有效治疗方法.
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