通过LOEM系统分层的慢性鼻炎的手术程度:系统性审查和元分析
Miriam González-García1, Lucía Prieto-Sánchez-de-Puerta2,3, Meritxell Clari-Comes4
1Rhinology Unit, Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario Virgen Macarena, Av. Dr. Fedriani 3, Seville, 41009, Spain. miriamgonga@hotmail.com.
概括
针对慢性鼻炎 (CRS) 的更广泛的内镜外科手术 (ESS) 会带来更好的结果,包括更少的修订和改善生活质量. 拉梅拉骨扩展性粘膜 (LOEM) 系统有助于分类手术扩展性,以便进行更清晰的比较.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术创新 在外科创新.
- 基于证据的医学基于证据的医学.
背景情况:
- 慢性鼻炎 (CRS) 的管理通常涉及内镜鼻手术 (ESS).
- 关于ESS对CRS的最佳程度仍在争论中.
- 拉梅拉骨扩展性粘液 (LOEM) 系统提供了一个标准化的方法来分类ESS程序.
研究的目的:
- 在CRS患者中,比较有限ESS与广泛ESS的临床结果.
- 根据Lamella Ostium Extent Mucosa (LOEM) 分类类别分析ESS结果.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 搜索的主要数据库 (PubMed,Embase,Cochrane,科学网,Scopus) 截至2025年4月.
- 包括13项研究 (2,024名患者),比较CRS的有限和广泛ESS,评估生活质量 (SNOT-22),症状严重程度 (VAS),复发率和修订率. 使用LOEM系统,程序被追溯分类.
主要成果:
- 扩展ESS手术 (LOEM 2-4) 显示出明显更好的结果,而不是有限的手术 (LOEM 1).
- 接受更广泛ESS治疗的患者经历了更少的修订和更低的复发率.
- 通过更广泛的手术方法观察到生活质量的更大改善 (SNOT-22得分),LOEM 4显示出最明显的症状缓解.
结论:
- 更广泛的内镜外科手术与慢性鼻炎管理的优异结果有关.
- LOEM系统为分层ESS手术和比较不同外科手术范围的结果提供了一个有价值的框架.
- 这些发现支持更全面的外科干预,以改善患者在CRS中的结果.
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