低温等离子消融术与常规剥离术在扁桃体切除术中疗效的Meta分析

Meta-analysis of the efficacy of low-temperature coblation and conventional resection

目的系统评价低温等离子消融术与常规剥离术在扁桃体切除术中的临床疗效。方法检索2009—年1月—2014年5月中国学术期刊、万方数据库、中国生物医学文献数据库、OVID、PubMed以及康健循证医学知识库,纳入有关低温等离子消融术和常规剥离术在扁桃体切除术中临床疗效的随机对照试验,对符合纳入标准的文献进行方法学的评价,并用RevMan5.2软件对符合质量标准的随机对照研究进行Meta分析。结果共纳入11个随机对照试验,合计1 061例患者,其中等离子组529例,常规剥离组532例。通过Meta分析表明:等离子组在手术时间、术中出血量、术后24 h疼痛评分及恢复正常饮食时间方面均优于常规剥离组,其差异均具有统计学意义(MD=-18.94,95%CI-23.90^-13.98,P<0.01;MD=-34.45,95%CI-39.43^-29.48,P<0.01;MD=-2.11,95%CI-2.23^-1.98,P<0.01;MD=-2.43,95%CI-3.19^-1.66),P<0.01);而在术后疼痛时间及白膜脱落时间上,2组差异均无统计学意义(MD=-0.94,95%Cl-2.24~0.35,P=0.15;MD=1.28,95%CI-0.40~2.97,P=0.13)。结论低温等离子消融术与常规剥离术相比,手术时间短,出血量极少,术后24 h疼痛轻,恢复正常饮食时间短,但在术后疼痛时间及白膜脱落时间方面2组结果相近,低温等离子消融术具有明显的优势,值得在临床中推广应用。

Objective To system review the clinical effect of low-temperature coblation and conventional resection tonsillectomy.Methods From 2009 January to 2014 May,retrieved Chinese Academic Journals,Wanfang database,China biomedical literature database,OVID,PubMed and health evidence-based medicine,collected randomized controlled trials of clinical curative effect of low-temperature coblation and conventional tonsil resection operation,reviewed the methodology of the these study,and carried on the Meta-analysis of these randomized controlled study using RevMan5.2 software.Results There were 11 randomized controlled trials,a total of 1 061 patients were included,the coblation group with 529 cases,conventional dissection group of 532 cases.The Meta analysis result showed:coblation group' s operation time,intraoperative bleeding volume,postoperative 24 h pain score and the resumption of normal diet were superior to conventional dissection group,the differences were statistically significant(MD =- 18.94,95%CI- 23.90 to- 13.98,P < 0.01;MD =-34.45,95%CI-39.43 to-29.48,P <0.01;MD =-2.11,95%CI-2.23 to-1.98,P <0.01;MD =-2.43,95%CI-3.19 to-1.66,P <0.01);while after operation's pain and the tunica albuginea shedding time revealed no significant differences between the 2 groups(MD =-0.94,95%CI-2.24 to 0.35,P =0.15;MD = 1.28,95%CI-0.40to-2.97,P =0.13).Conclusion Compared with the conventional dissection operation,low-temperature coblation has the advantage of short operation time,minimal blood loss,postoperative 24 h relieve pain,short normal diet recovery time,but in the postoperative pain and the tunica albuginea shedding time were similar between the 2 groups,the low-temperature coblation has obvious advantages,it is worthy of clinical application.