鼓膜穿刺与鼓膜置管治疗鼻咽癌放疗后分泌性中耳炎的Meta分析
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Auripuncture and Grommet Insertion for PostirradiationSecretory otitis media in Patients with Nasopharyngeal Carcinoma: A Metaanalysis
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    目的 应用Meta分析方法评价鼓膜穿刺与鼓膜置管治疗鼻咽癌(nasopharyngeal carcinomal, NPC)放疗后分泌性中耳炎(secretory otitis media, SOM)的疗效差异,为临床治疗选择提供依据。方法 电子检索Pubmed、Embase及中文期刊数据库(CBM,CNKI及CSTJ),获取对照鼓膜穿刺与鼓膜置管治疗NPC放疗后SOM的临床研究资料;用Stata9.2统计软件包进行Meta分析。结果 共纳入符合要求的研究5篇,合计患者352例(484耳);Meta分析结果显示两者在有效率上的差异无统计学意义[RR=1.02,95%CI(0.78,1.32)];而鼓膜置管组并发症的发生率高于鼓膜穿刺组[RR=0.25,95%CI(0.14,0.44)]。结论 在NPC放疗后SOM患者的初次治疗中,鼓膜穿刺和鼓膜置管的疗效相似,鼓膜置管比鼓膜穿刺更易发生并发症。以上分析结果提示,对于初次治疗的患者选择并发症发生率相对较小的鼓膜穿刺更合理。

    Abstract:

    Objective Secretory otitis media (SOM) is one of the most common complications in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Both auripuncture and grommet insertion are promising operation techniques to treat postirradiation SOM. However, it is still controversial that which therapy is more beneficial. This metaanalysis was undertaken to compare curative effect between auripuncture and grommet insertion for postirradiation SOM and to provide suggestion for clinical treatment choice. To make this analysis, Pubmed, Embase, CBM, CNKI and CSTJ were searched by March 2011 for relative clinical trials; STATA 9.2 was used for conducting the statistical analysis. Finally, 5 trials with 352 patients and 484 ears were included. The results of the metaanalysis showed that there was no significant difference in the effective rate between the two therapies [RR=1.02, 95%CI(0.78, 1.32)], yet grommet insertion has higher complication rate [RR=0.25, 95%CI(0.14,0.44)]. According to the results, auripuncture and grommet insertion are similar in therapeutic effect for SOM after radiotherapy in patients with NPC. However, grommet insertion has higher risk of complications. Results Indicate that, for the first treated patients, it is more reasonable to choose the treatment of auripuncture for its relatively less incidence rate of complication.

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宾翔 周永 张诚 甘媚.鼓膜穿刺与鼓膜置管治疗鼻咽癌放疗后分泌性中耳炎的Meta分析[J].中国耳鼻咽喉颅底外科杂志,2011,17(6):438-442

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  • 在线发布日期: 2011-12-31
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