听力学及言语疾病杂志
聽力學及言語疾病雜誌
은역학급언어질병잡지
Journal of Audiology and Speech Pathology
2015年
6期
637-642
,共6页
吴婷婷%张岑%彭涛%孙开宇
吳婷婷%張岑%彭濤%孫開宇
오정정%장잠%팽도%손개우
完壁式乳突根治术%开放式乳突根治术%胆脂瘤中耳炎%疗效%M eta分析
完壁式乳突根治術%開放式乳突根治術%膽脂瘤中耳炎%療效%M eta分析
완벽식유돌근치술%개방식유돌근치술%담지류중이염%료효%M eta분석
Intact canal wall mastoidectomy%Open mastoidectomy%Cholesteatoma otitis media%Thera-peutic effect%M eta-analysis
目的:通过M eta分析的方法对国内报道的完壁式与开放式乳突根治术治疗胆脂瘤中耳炎疗效的文献进行系统评价。方法计算机检索维普中文科技期刊全文数据库(VIP)(1989~2015年)、中国万方数据库(1999~2015年)、中国知网(CNKI)(1994~2015年)、学术期刊网络出版总库(CAJD)数据库中关于应用完壁式与开放式乳突根治术治疗胆脂瘤中耳炎的临床随机对照试验(RCT )的国内相关文献,对符合要求的RCT进行M eta分析。结果最终纳入符合标准的文献18篇,共有1069例患者,随访时间3个月~7年不等;M eta分析结果显示,完壁式乳突根治术组比开放式乳突根治术组的手术时间短[总效应 Z=15.54, M D=-18.36,95% CI (-24.54,-12.18),P<0.00001],干耳时间短[总效应Z=8.64,MD=-13.90,95% CI(-17.05,-10.75), P<0.00001],并发症少[总效应Z=7.63,OR=0.19,95% CI(0.12,0.29), P<0.00001],术后气导听阈降低>10 dB的病例多[总效应Z=2.83,OR=2.47,95% CI(1.32,4.61), P=0.005],气骨导差<20 dB的病例多[总效应Z=3.05,OR=1.60,95% CI(1.18,2.17),P=0.002],两种术式复发率差异无统计学意义[总效应Z=1.92,OR =1.87,95% CI(0.99,3.53),P=0.05]。结论在两种手术方式均可行的情况下,完壁式乳突根治术较开放式乳突根治术治疗胆脂瘤中耳炎的手术时间及干耳时间短,并发症少,术后听力提高更优,但复发率无明显差异。
目的:通過M eta分析的方法對國內報道的完壁式與開放式乳突根治術治療膽脂瘤中耳炎療效的文獻進行繫統評價。方法計算機檢索維普中文科技期刊全文數據庫(VIP)(1989~2015年)、中國萬方數據庫(1999~2015年)、中國知網(CNKI)(1994~2015年)、學術期刊網絡齣版總庫(CAJD)數據庫中關于應用完壁式與開放式乳突根治術治療膽脂瘤中耳炎的臨床隨機對照試驗(RCT )的國內相關文獻,對符閤要求的RCT進行M eta分析。結果最終納入符閤標準的文獻18篇,共有1069例患者,隨訪時間3箇月~7年不等;M eta分析結果顯示,完壁式乳突根治術組比開放式乳突根治術組的手術時間短[總效應 Z=15.54, M D=-18.36,95% CI (-24.54,-12.18),P<0.00001],榦耳時間短[總效應Z=8.64,MD=-13.90,95% CI(-17.05,-10.75), P<0.00001],併髮癥少[總效應Z=7.63,OR=0.19,95% CI(0.12,0.29), P<0.00001],術後氣導聽閾降低>10 dB的病例多[總效應Z=2.83,OR=2.47,95% CI(1.32,4.61), P=0.005],氣骨導差<20 dB的病例多[總效應Z=3.05,OR=1.60,95% CI(1.18,2.17),P=0.002],兩種術式複髮率差異無統計學意義[總效應Z=1.92,OR =1.87,95% CI(0.99,3.53),P=0.05]。結論在兩種手術方式均可行的情況下,完壁式乳突根治術較開放式乳突根治術治療膽脂瘤中耳炎的手術時間及榦耳時間短,併髮癥少,術後聽力提高更優,但複髮率無明顯差異。
목적:통과M eta분석적방법대국내보도적완벽식여개방식유돌근치술치료담지류중이염료효적문헌진행계통평개。방법계산궤검색유보중문과기기간전문수거고(VIP)(1989~2015년)、중국만방수거고(1999~2015년)、중국지망(CNKI)(1994~2015년)、학술기간망락출판총고(CAJD)수거고중관우응용완벽식여개방식유돌근치술치료담지류중이염적림상수궤대조시험(RCT )적국내상관문헌,대부합요구적RCT진행M eta분석。결과최종납입부합표준적문헌18편,공유1069례환자,수방시간3개월~7년불등;M eta분석결과현시,완벽식유돌근치술조비개방식유돌근치술조적수술시간단[총효응 Z=15.54, M D=-18.36,95% CI (-24.54,-12.18),P<0.00001],간이시간단[총효응Z=8.64,MD=-13.90,95% CI(-17.05,-10.75), P<0.00001],병발증소[총효응Z=7.63,OR=0.19,95% CI(0.12,0.29), P<0.00001],술후기도은역강저>10 dB적병례다[총효응Z=2.83,OR=2.47,95% CI(1.32,4.61), P=0.005],기골도차<20 dB적병례다[총효응Z=3.05,OR=1.60,95% CI(1.18,2.17),P=0.002],량충술식복발솔차이무통계학의의[총효응Z=1.92,OR =1.87,95% CI(0.99,3.53),P=0.05]。결론재량충수술방식균가행적정황하,완벽식유돌근치술교개방식유돌근치술치료담지류중이염적수술시간급간이시간단,병발증소,술후은력제고경우,단복발솔무명현차이。
Objective To carry out a meta-analysis on the published data to evaluate therapeutic effects of intact canal wall mastoidectomy and open mastoidectomy for cholesteatoma otitis media .Methods A comprehensive search was performed in VIP (1989-2015) ,WANFANG (1999-2015) ,CNKI (1994-2015) and CAJD databases to collect the randomized controlled trials (RCTs) on the intact canal wall mastoidectomy and open mastoidectomy treat cholesteatoma otitis media ,and to analyze the RCTs in meta -analysis method .Results 1 069 patients were analyzed in the 18 RCTs which met the inclusion criteria .Patients were followed up from 3 months to 7 years .The meta-analysis results suggested that ,compared with the open mastoidectomy group ,the patients had less operative time (test for overall effect :Z=15 .54 ,MD= -18 .36 ,95% CI(-24 .54 ,-12 .18) , P<0 .000 01) ,less dry ear time (test for overall effect :Z=8 .64 ,MD= -13 .90 ,95% CI(-17 .05 ,-10 .75) , P<0 .000 01) ,less complica‐tions (test for overall effect :Z=7 .63 ,OR=0 .19 ,95% CI(0 .12 ,0 .29) , P<0 .000 01) ,and more patients with decreased pure tone air conduction thresholds >10 dB (test for overall effect:Z=2 .83 ,OR=2 .47 ,95% CI(1 .32 , 4 .61) ,P=0 .005) ,more patients with air-bone gaps <20 dB(Z=3 .05 ,OR=1 .60 ,95% CI(1 .18 ,2 .17) ,P=0 .002) ,but the recurrent rate is not different significantly (test for overall effect :Z= 1 .92 ,OR =1 .87 ,95% CI (0 .99 ,3 .53) ,P=0 .05) .Conclusion The illness is suitable to be treated by using the two surgical ways while the intact canal wall mastoidectomy treatment takes less operative time ,dry ear time and complications ,and improve hearing more significantly than the open mastoidectomy ,but the recurrent rate is not different significantly for trea‐ting cholesteatoma otitis media .