Zheng Jingqiong, Yu Lingyan, Hu Wenhui, Yu Yijian
Department of Otolaryngology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
Department of Emergency, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
Transl Pediatr. 2022 Jul;11(7):1171-1181. doi: 10.21037/tp-22-189.
At present, the surgical treatment of sinusitis with nasal polyps has made great progress, but its recurrence rate is still high. Therefore, this time, meta-analysis is used to study the therapeutic effect of endoscopic sinus surgery on children with chronic sinusitis with nasal polyps, analyze its effectiveness and safety, and provide theoretical basis for clinical treatment.
Boolean logic searching was adopted to retrieve articles from various databases, including PubMed, Medline, and Chinese National Knowledge Infrastructure (CNKI), published from the establishment of the database to December 30, 2021. The following search terms were used: "endoscopic sinus surgery", "antrochoanal polyps", "chronic sinusitis with nasal polyps", and "nasal polyps". Comparative studies on traditional surgical treatment and endoscopic sinus surgery were also screened out. Review Manager was utilized for meta-analysis.
A total of 9 references were included in the study, and most of them were low risk bias (medium and high quality). Meta-analysis showed that there was no statistical heterogeneity between the control group and the experimental group (Chi=0.03, I=0%, P=0.98). According to the fixed effect model analysis, the number of patients with polyp formation in the experimental group was significantly less than that in the control group (Z=2.65, P=0.008). Compared with the control group, there is no statistical heterogeneity in the postoperative recurrence (Chi=1.59, I=0%, P=0.45). According to the analysis of fixed effect model, the postoperative recurrence in the experimental group is significantly less than that in the control group (Z=2.92, OR =2.78, 95% CI: 1.40-5.52, P=0.004). Compared with the control group, the results of postoperative visual analogue scale (VAS) were statistically different (Chi=12.63, I=84%, P=0.002). According to the random effect model analysis, the VAS score of the experimental group was significantly lower than that of the control group (Z=18.06, MD =4.51, 95% CI: 3.96-5.05, P<0.00001).
Endoscopic sinus surgery could reduce the postoperative recurrence and pain of patients, and showed high curative effects and safety in the treatment of children with chronic sinusitis with nasal polyps.
目前，鼻窦炎伴鼻息肉的外科治疗已取得很大进展，但其复发率仍然较高。因此，此次采用荟萃分析研究鼻内镜手术治疗儿童慢性鼻窦炎伴鼻息肉的疗效，分析其有效性和安全性，为临床治疗提供理论依据。
采用布尔逻辑检索从多个数据库中检索文章，包括PubMed、Medline和中国知网（CNKI），检索时间从数据库建立至2021年12月30日。使用以下检索词：“鼻内镜手术”“腺样体息肉”“慢性鼻窦炎伴鼻息肉”和“鼻息肉”。还筛选出传统手术治疗与鼻内镜手术的对比研究。使用Review Manager进行荟萃分析。
该研究共纳入9篇参考文献，其中大部分为低风险偏倚（中高质量）。荟萃分析显示，对照组与试验组之间无统计学异质性（卡方=0.03，I²=0%，P=0.98）。根据固定效应模型分析，试验组息肉形成患者数量显著少于对照组（Z=2.65，P=0.008）。与对照组相比，术后复发无统计学异质性（卡方=1.59，I²=0%，P=0.45）。根据固定效应模型分析，试验组术后复发显著少于对照组（Z=2.92，OR=2.78，95%CI：1.40-5.52，P=0.004）。与对照组相比，术后视觉模拟评分（VAS）结果有统计学差异（卡方=12.63，I²=84%，P=0.002）。根据随机效应模型分析，试验组VAS评分显著低于对照组（Z=18.06，MD=4.51，95%CI：3.96-5.05，P<0.00001）。
鼻内镜手术可降低患者术后复发率和疼痛程度，在治疗儿童慢性鼻窦炎伴鼻息肉方面显示出较高的疗效和安全性。
