涎腺内镜治疗后生活质量：前瞻性非随机研究。
Quality of life after sialendoscopy: prospective non-randomized study.
机构信息
Department of Otorhinolaryngology and Surgery of Head and Neck, Federal University of São Paulo/Paulista School of Medicine (UNIFESP/EPM), R. Maestro Cardim, 560 cj 24 Bela Vista, São Paulo, SP, CEP 01323000, Brazil.
Department of Head and Neck Surgery, Beneficencia Portuguesa of Sao Paulo Hospital, Sao Paulo, SP, Brazil.
出版信息
BMC Surg. 2022 Jan 8;22(1):11. doi: 10.1186/s12893-021-01462-2.
BACKGROUND
The symptomatic (swelling and pain) salivary gland obstructions are caused by sialolithiasis and salivary duct stenosis, negatively affecting quality of life (QOL), with almost all candidates for clinical measures and minimally invasive sialendoscopy. The impact of sialendoscopy treatment on the QOL has been little addressed nowadays. The objective is to prospectively evaluate the impact of sialendoscopy on the quality of life of patients undergoing sialendoscopy due to benign salivary obstructive diseases, measured through QOL questionnaires of xerostomia degree, the oral health impact profile and post sialendoscopy satisfaction questionnaires.
RESULT
37 sialendoscopies were included, most young female; there were 64.5% sialolithiasis and 35.4% post-radioiodine; with 4.5 times/week painful swelling symptoms and 23.5 months symptom duration. The pre- and post-sialendoscopy VAS values were: 7.42 to 1.29 (p < 0.001); 86.5% and 89.2% were subjected to sialendoscopy alone and endoscopic dilatation respectively; 80.6% reported improved symptoms after sialendoscopy in the sialolithiasis clinic (p < 0.001). The physical pain and psychological discomfort domain scores were mostly impacted where sialendoscopy provided relief and improvement (p < 0.001). We found a positive correlation between sialendoscopy and obstructive stone disease (p < 0.001) and no correlation in sialendoscopy satisfaction in xerostomia patients (p = 0.009).
CONCLUSIONS
We found improved symptoms with overall good satisfaction after sialendoscopy correlated with stones; and a negative correlation between xerostomia. Our findings support the evident indication of sialendoscopy for obstructive sialolithiasis with a positive impact on QOL and probably a relative time-dependent indication for stenosis/other xerostomia causes that little improved QOL satisfaction.
LEVEL OF EVIDENCE
2b-Prospective non-randomized study.
TRIAL REGISTRATION
WHO Universal Trial Number (UTN): U1111-1247-7028; Brazilian Clinical Trials Registry (ReBeC): RBR-6p8zfs.
背景
有症状（肿胀和疼痛）的唾液腺阻塞是由涎石病和唾液管狭窄引起的，会降低生活质量（QOL），几乎所有候选者都需要进行临床治疗和微创唾液腺内镜检查。目前，唾液腺内镜治疗对 QOL 的影响还没有得到充分的研究。本研究的目的是前瞻性评估因良性唾液腺阻塞性疾病而接受唾液腺内镜治疗的患者的 QOL 影响，通过口干程度、口腔健康影响简表和唾液腺内镜治疗后满意度问卷来衡量。
结果
共纳入 37 例唾液腺内镜治疗，患者以年轻女性为主；涎石病占 64.5%，放射性碘治疗后占 35.4%；每周有 4.5 次疼痛性肿胀症状，症状持续时间为 23.5 个月。唾液腺内镜治疗前后 VAS 值分别为：7.42 至 1.29（p<0.001）；分别有 86.5%和 89.2%的患者单独接受唾液腺内镜治疗和内镜扩张；80.6%的涎石病患者报告在唾液腺内镜治疗后症状得到改善（p<0.001）。物理疼痛和心理不适的评分受到唾液腺内镜治疗的影响最大，提供了缓解和改善（p<0.001）。我们发现唾液腺内镜治疗与阻塞性结石疾病呈正相关（p<0.001），而在口干患者的唾液腺内镜治疗满意度方面无相关性（p=0.009）。
结论
我们发现唾液腺内镜治疗后症状改善，总体满意度较高，与结石相关；与口干呈负相关。我们的研究结果支持阻塞性涎石病行唾液腺内镜治疗的明确适应证，对 QOL 有积极影响，而对狭窄/其他口干原因的适应证可能是相对时间依赖性的，对 QOL 满意度的改善较小。
证据水平
2b 级前瞻性非随机研究。
试验注册
世界卫生组织通用试验编号（UTN）：U1111-1247-7028；巴西临床试验注册处（ReBeC）：RBR-6p8zfs。
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