低温等离子刀扁桃体切除术疗效的Meta分析

Meta analysis of effect of hypothermia plasma ablation on tonsillectomy

  • 摘要: 目的 评价低温等离子刀扁桃体切除术和传统扁桃体剥离术的疗效及安全性。 方法 检索2000 - 2013年PubMed、EMbase、万方数据库、中国知网中关于低温等离子刀扁桃体切除术的随机对照试验(randomized controlled trials,RCTs),对纳入研究应用考克兰系统评价数据库(Cochrane Database of Systematic Reviews)标准进行评价,对符合标准的文献用Review manager 5.1软件进行Meta分析。 结果 14个RCTs共1 240例患者纳入研究,其中观察组(低温等离子刀扁桃体切除术)607例,对照组(传统扁桃体剥离术) 633例。Meta分析结果提示,观察组术中出血量低于对照组Md= -2.36,95% CI (-2.56 ~-2.17),P< 0.001;手术时间较对照组短Md= -2.16,95% CI (-2.33 ~ -1.99),P< 0.001;两组术后出血发生率差异无统计学意义MD= 0.54,95% CI (0.25 ~ 1.17),P> 0.05。 结论 低温等离子刀扁桃体切除疗效要优于传统扁桃体剥离术。但两者在术后出血发生率上无统计学差异。

     

    Abstract: Objective To compare the clinical efficacy and safety of argon plasma coagulation (APC) tonsillectomy and conventional tonsillectomy. Methods Randomized controlled trials (RCTs) about APC tonsillectomy from 2000 to 2013 were collected by searching databases such as PubMed, EMbase, Wanfang Data and China Hownet. Then RCTs were evaluated based on the Cochrane Database of Systematic Reviews, and meta-analysis was completed by Review Manager 5.1. Results Fourteen essays were enrolled in this research which included totally 1 240 cases. Of the 1 240 cases, 607 cases were in observation group (argon plasma coagulation tonsillectomy) and 633 cases were in control group (conventional tonsillectomy). The results of meta-analysis revealed that the intraoperative blood loss of observation group was significantly lower than that of control group Md= -2.36, 95% CI (-2.56 - -2.17), P< 0.001, the operation time of observation group was significantly shorter than that of control group Md= -2.16, 95% CI (-2.33 - -1.99), P< 0.001. However, there was no significant difference between the two groups about postoperative hemorrhage Md= 0.54, 95% CI (0.25 - 1.17), P> 0.05. Conclusion Clinical efficacy of APC tonsillectomy is better than conventional tonsillectomy, and the intraoperative blood loss between the two groups is of no significant difference.

     

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