山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (6): 63-71.doi: 10.6040/j.issn.1673-3770.0.2019.570
谭凤武,邓亚萍,黎可华
TAN Fengwu, DENG Yaping, LI Kehua
摘要: 目的 采用Meta分析的方法评价支撑喉镜下低温等离子射频消融与CO2激光治疗早期声门型喉癌的临床疗效。 方法 计算机检索PubMed、EMbase、Medline、维普、万方、CNKI数据库。检索年限从建库至2019年5月1日。同时手检纳入文献的参考文献。根据纳入标准和排除标准筛选关于比较支撑喉镜下低温等离子射频消融术与CO2激光手术治疗早期声门型喉癌疗效的文献。由2人单独进行文献的筛选、数据提取及文献的评价,使用Revman 5.3软件进行Meta分析。 结果 共纳入10个研究,1 055例患者。Meta分析结果显示:与CO2激光手术相比,低温等离子射频消融术显著降低了患者的手术时间[SMD=-2.97,95%CI(-4.05,-1.90),P<0.00 001 ]、术后黏膜恢复更快[OR=5.53,95%CI(2.84,10.78), P<0.00 001]、术中出血量更多[SMD=-0.73,95%CI(0.09,0.71),P=0.01],以上两种手术方式相比差异有统计学意义。复发率[OR=0.79,CI95%(0.46,1.36), P=0.39]、术后疼痛程度[SMD=-0.17,95%CI(-0.43,0.08),P=0.18]和术后发声质量[SMD=-0.21,95%CI(-1.13,0.71), P=0.65]两种治疗方式相比差异无统计学意义。手术时间及复发率的漏斗图未发现明显发表偏倚。 结论 低温等离子射频消融术治疗早期声门型喉癌在手术时间和术后黏膜恢复方面优于CO2激光手术,但低温等离子射频消融术的术中出血量较多,而复发率、术后疼痛程度和术后发声质量,两种治疗方式相比差异无统计学意义。
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