瑞纳凝胶和膨胀海绵用于鼻出血和鼻腔术后填塞的Meta分析

Rena gel versus expansive sponge for nasal bleeding and postoperative nasal packing: a Meta-analysis

背景:瑞纳凝胶和膨胀海绵是两种常用的鼻腔填塞材料,但目前尚缺乏对两种材料具体填塞效果的全面分析。目的:对比鼻出血和鼻腔术后填塞瑞纳凝胶和膨胀海绵的临床效果及不良反应发生情况。方法:利用计算机检索中国生物医学文献数据库和Pub Med数据库、EMBASE、Cochrane图书馆等,检索词为"瑞纳凝胶,随机对照,膨胀海绵;Rena gel,randomized,expansive sponge",纳入瑞纳凝胶与膨胀海绵填塞的随机对照试验,对填塞和移除时的疼痛感、胀痛感、出血情况、出血控制情况及难易程度进行Meta分析。结果与结论:共纳入4个随机对照试验,包含115例患者。膨胀海绵组填塞与移除时的疼痛感均高于瑞纳凝胶组(P<0.05);两组填塞6 h的疼痛感无差异(P>0.05)。膨胀海绵组填塞1,6 h的胀痛感显著高于瑞纳凝胶组(P<0.05)。两组填塞时的出血情况无差异(P>0.05);膨胀海绵组移除时的出血情况重于瑞纳凝胶组(P<0.05)。两种填塞材料的出血控制情况无差异(P>0.05)。膨胀海绵组的填塞和移除难度均大于瑞纳凝胶组(P<0.05)。表明在使用时引发的疼痛、肿痛及填塞和移除时导致的出血方面,瑞纳凝胶较膨胀海绵相对较轻,但在出血控制方面两种材料效果基本相同。

BACKGROUND： Rena gel and expansive sponge are two kinds of nasal packing materials, but there is still a lack of comprehensive analysis on their filling effects. OBJECTIVE： To compare the therapeutic efficacy of Rena gel and expansive sponge on nasal hemorrhage and postoperative nasal packing as well as adverse reactions. METHODS： A computer-based search of CBM, Pub Med, EMBASE, Cochrane Library was performed for articles addressing randomized controlled trials of Rena gel and expansive sponge as filling materials. The keywords were ＂Rena gel, randomized controlled, expansive sponge＂ in Chinese and English, respectively. Then, aching feeling during filling and removal, swelling pain, bleeding, and bleeding control were compared and analyzed through a Meta-analysis. RESULTS AND CONCLUSION： There were four randomized controlled trials, involving 115 patients. The severity of pain was higher in the expansive sponge group than the Rena gel group when the filling materials were placed or removed（P〈0.05）. However, there was no difference in the severity of pain between the two groups at 6 hours of filling（P〉0.05）. The severity of swelling pain was higher in the expansive sponge group than the Rena gel group at 1 and 6 hours after filling（P〈0.05）. When the filling materials were removed, the expansive group showed more severe bleeding than the Rena gel group（P〈0.05）. No differences in thebleeding when filling and bleeding control were found between the two groups（P〉0.05）. In addition, it was more difficult to fill or remove the expansive sponge from the nasal cavity（P〈0.05）. These findings indicate that the Rena gel is superior to the expansive sponge in terms of pain, swelling pain, and bleeding when filling or removing the materials. But there is no difference in bleeding control between the two kinds of filling materials.