经鼻内镜鼻腔鼻窦内翻性乳头状瘤手术术后复发率的Meta分析

The recurrent rate of nasal endoscopic microsurgical skills for the treatment of nasal inverted papilloma:a Meta-analysis

目的:探讨鼻内镜技术对鼻腔鼻窦内翻性乳头状瘤(NIP)手术术后复发率的影响。方法:检索Pubmed、Medline、Springer、Elsevier等全文数据库,通过Meta分析,使用Revman 5.0软件分析2001-2013年间关于不同手术方式治疗NIP的研究。结果:纳入研究文献12篇,发表时间为2001-2013年,病例总数共1 371例,内翻性乳头状瘤复发234例,总体复发率为17.1%。对纳入研究的12篇文献进行异质性分析,结果显示异质性检验Q=14.64,df=11,P=0.20,表明12篇文献的研究属于同一性质。采用固定效应模型对12个研究进行合并分析,合并后鼻内镜组1 012例,常规手术组359例,合并OR=0.49,95%CI(0.35,0.69),对合并OR的检验结果为Z=4.11(P<0.01),提示鼻内镜组复发率低于非鼻内镜组,差异有统计学意义。漏斗图提示发表偏倚较小。结论:鼻内镜手术可有效控制NIP手术的术后复发率。

Objective： To investigate the recurrence rate of nasal inverted papilloma treating by endoscopic and non-en- doscopic approach. Method：A search on Pubmed, Medline, Springer and Elsevier databases was done to collect the reports （2001--2013） concerning different surgery treating nasal inverted papillomas, and recta-analysis was performed with RevMan 5.0 software. Result： Twelve papers （2001 -- 2013） concerning the different surgery approach treating nasal in- verted papillomas were retrieved. The heterogeneity test indicated that the 12 studies were consistent statistically （Q= 14.64, d f= ll ,P=0. 20）, the data from these 12 studies could be analyzed by fixed effect model. After combination of these data, those of 1 012 subjects accepted endoscopic surgical intervention and 359 subjects treating by non-endoscopic surgical intervention were collected. Test of overall effect by fixed effect model showed that the recurrence rate of inverted papilloma was significantly lower in endoscopic group than in non-endoscopic group （OR = 0. 49, 95 % CI was 0.35- 0. 69, P〈0.01）. Funnel plot implied that publication bias was not obvious. Conclusion： The recurrence rate of inverted papilloma was significantly lower in endoscopic group than in non-endoscopic group.