博来霉素硬化疗法治疗淋巴管畸形的疗效：综述和荟萃分析。
The efficacy of bleomycin sclerotherapy in the treatment of lymphatic malformations: a review and meta-analysis.
机构信息
Children's Hospital Affiliated to Shandong University, Department of Vascular anomalies and Interventional Radiology, Shandong, China.
Children's Hospital Affiliated to Shandong University, Department of Vascular anomalies and Interventional Radiology, Shandong, China; Jinan Children's Hospital, Department of Vascular Anomalies and Interventional Radiology, Jinan, China; Shandong Provincial Clinical Research Center for Children's Health and Disease, Shandong, China.
出版信息
Braz J Otorhinolaryngol. 2023 Jul-Aug;89(4):101285. doi: 10.1016/j.bjorl.2023.101285. Epub 2023 Jun 29.
OBJECTIVE
At present, bleomycin has been widely used in the treatment of Lymphatic Malformations (LMs). This study aims to perform a meta-analysis to investigate the effectiveness and influencing factors of bleomycin in the treatment of LMs.
METHODS
We conducted a systematic review and meta-analysis to clarify the relationship between bleomycin and LMs. PubMed, ISI Web of Science and MEDLINE were searched.
RESULTS
A total of 21 studies (including 428 cases) about bleomycin sclerotherapy for LMs were included in the current meta-analyses. We calculated pooled effective rate and 95% Confidence Interval (95% CI) using random effects model to evaluate the relations between bleomycin and LMs. The results suggested that the effective rate of bleomycin was the combined effective rate was 84.0% (95% CI 0.81‒0.87) and ranged from 39% (95% CI 0.22‒0.56) to 94% (95% CI 0.87-1.02). The heterogeneity among the studies was substantial (I=61.7%, p= 0.000). In subgroup analyses, it was observed that among retrospective study and prospective study, the estimated effective rate was 80.0% (95% CI 0.76‒0.84) and 91.0% (95% CI 0.85‒0.97), respectively. In terms of the dosage, the combined effective rates of weight-based group and fixed-dose group were 86% (95% CI 0.83‒0.90) and 74.0% (95% CI 0.66‒0.82), respectively. There was no significant publication bias in Egger's test (p=0.059, 95% CI -3.81 to 0.082), but Begg's test did (p=0.023), and the funnel plot is asymmetric.
CONCLUSION
Our study suggested that bleomycin was safe and effective in the treatment of LMs and was primarily dose dependent.
目的
目前，平阳霉素已广泛应用于淋巴管畸形（LMs）的治疗。本研究旨在进行荟萃分析，以探讨平阳霉素治疗 LMs 的疗效及其影响因素。
方法
我们进行了系统评价和荟萃分析，以阐明平阳霉素与 LMs 之间的关系。检索了 PubMed、ISI Web of Science 和 MEDLINE。
结果
共纳入了 21 项关于平阳霉素硬化治疗 LMs 的研究（共 428 例），采用随机效应模型计算合并有效率及其 95%置信区间（95%CI），以评估平阳霉素与 LMs 之间的关系。结果表明，平阳霉素的有效率为联合有效率为 84.0%（95%CI 0.81‒0.87），范围为 39%（95%CI 0.22‒0.56）至 94%（95%CI 0.87-1.02）。各研究间存在较大异质性（I=61.7%，p=0.000）。亚组分析显示，在回顾性研究和前瞻性研究中，估计有效率分别为 80.0%（95%CI 0.76‒0.84）和 91.0%（95%CI 0.85‒0.97）。按剂量分组，体重组和固定剂量组的联合有效率分别为 86%（95%CI 0.83‒0.90）和 74.0%（95%CI 0.66‒0.82）。Egger 检验未发现发表偏倚（p=0.059，95%CI -3.81 至 0.082），但 Begg 检验发现存在发表偏倚（p=0.023），漏斗图不对称。
结论
本研究表明，平阳霉素治疗 LMs 安全有效，主要与剂量有关。
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