The Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway; Department of Clinical Science, Section for Paediatrics, University of Bergen, Norway.
The Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
Paediatr Respir Rev. 2018 Jun;27:74-85. doi: 10.1016/j.prrv.2017.11.001. Epub 2017 Nov 15.
Extremely premature (EP) infants are at increased risk of left vocal cord paralysis (LVCP) following surgery for patent ductus arteriosus (PDA).
A Systematical Review was conducted to investigate the incidence and outcomes of LVCP after PDA ligation in EP born infants.
Searches were performed in Cochrane, Medline, Embase, Cinahl and PsycInfo.
Studies describing EP infants undergoing PDA surgery and reporting incidence of LVCP were included.
Study details, demographics, incidence of LVCP, diagnostic method and reported outcomes were extracted. DerSimonian and Laird random effect models with inverse variance weighting were used for all analyses.
The Newcastle-Ottawa scale for observational studies was used for quality assessment.
21 publications including 2067 infants were studied. The overall pooled summary estimate of LVCP incidence was 9.0% (95% CI 5.0, 15.0). However, the pooled incidence increased to 32% when only infants examined with laryngoscopy were included. The overall risk ratio for negative outcomes was higher in the LVCP group (2.20, 95% CI 1.69, 2.88, p = 0.01) compared to the non-LVCP-group.
Reported incidence of LVCP varies widely. This may be explained by differences in study designs and lack of routine vocal cords postoperative assessment. LVCP is associated with negative outcomes in EP infants. The understanding of long-term outcomes is scarce. Routine laryngoscopy may be necessary to identify all cases of LVCP, and to provide correct handling for infants with LVCP.
极早产儿（EP）在患有动脉导管未闭（PDA）的情况下接受手术治疗后，发生左侧声带麻痹（LVCP）的风险增加。
系统评价旨在研究 EP 早产儿行 PDA 结扎术后发生 LVCP 的发生率和结局。
在 Cochrane、Medline、Embase、Cinahl 和 PsycInfo 中进行检索。
纳入描述 EP 婴儿接受 PDA 手术并报告 LVCP 发生率的研究。
提取研究细节、人口统计学数据、LVCP 发生率、诊断方法和报告结局。所有分析均采用 DerSimonian 和 Laird 随机效应模型，采用倒数方差加权。
采用 Newcastle-Ottawa 量表对观察性研究进行质量评估。
共纳入 21 项研究，共计 2067 名婴儿。LVCP 总发生率的汇总估计值为 9.0%（95%CI 5.0，15.0）。然而，当仅纳入接受喉镜检查的婴儿时，汇总发生率增加至 32%。与非 LVCP 组相比，LVCP 组的不良结局风险比更高（2.20，95%CI 1.69，2.88，p=0.01）。
报告的 LVCP 发生率差异很大。这可能是由于研究设计的差异以及缺乏术后声带常规评估所致。LVCP 与 EP 婴儿的不良结局相关。对长期结局的理解尚不清楚。常规喉镜检查可能有必要识别所有 LVCP 病例，并为 LVCP 婴儿提供正确的处理。
