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声门下气管狭窄的肺功能检查:系统评价和荟萃分析。

Spirometry in laryngotracheal stenosis: a systematic review and meta-analysis.

机构信息

Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia.

Department of Otolaryngology-Head and Neck Surgery, Maternity and Children Hospital, Makkah, Saudi Arabia.

出版信息

Eur Arch Otorhinolaryngol. 2023 Nov;280(11):4783-4792. doi: 10.1007/s00405-023-08159-7. Epub 2023 Jul 31.

Abstract

PURPOSE

This study aimed to assess the changes in spirometry parameters or indices after relieving laryngotracheal stenosis (LTS) in adult patients.

METHODS

A systematic review and meta-analysis of studies from PubMed, Scopus, Web of Science, Cochrane Library, and EBSCO databases was conducted for assessing changes in spirometry values after endoscopic balloon dilatation of LTS in adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Relevant data, such as changes in mean spirometry values between preoperative and postoperative interventions, and findings of receiver operating characteristic curve analyses for predicting the need for surgical intervention, were extracted.

RESULTS

Ten studies including 330 patients overall met the inclusion criteria. Significant improvements were observed from preoperative to postoperative mean values of different spirometry parameters and indices. The overall mean differences in peak expiratory flow (ΔPEF), expiratory disproportion index (ΔEDI), and peak inspiratory flow (ΔPIF) were 2.26 L/s (95% CI 2.14-2.38), 27.94 s (95% CI 26.36-29.52), and 1.21 L/s (95% CI 0.95-1.47), respectively. ΔPEF and ΔPIF values increased, while ΔEDI decreased. In predicting the need for surgical intervention, EDI had the highest sensitivity (88%), and forced expiratory volume per second/forced vital capacity had the highest specificity (85%).

CONCLUSION

Spirometry is a valuable tool for assessing patients with LTS. PEF, EDI, and PIF were the most commonly reported spirometry parameters that significantly improved after airway stenosis was relieved.

摘要

目的

本研究旨在评估成人喉气管狭窄(LTS)松解后肺功能参数或指标的变化。

方法

系统检索 PubMed、Scopus、Web of Science、Cochrane 图书馆和 EBSCO 数据库中有关成人内镜下球囊扩张治疗 LTS 后肺功能值变化的研究,采用系统评价和荟萃分析 Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)指南。提取相关数据,如术前和术后干预措施之间平均肺功能值的变化,以及预测是否需要手术干预的受试者工作特征曲线分析结果。

结果

共有 10 项研究纳入 330 例患者,符合纳入标准。与术前相比,不同肺功能参数和指标的术后平均数值均有显著改善。呼气峰流量(ΔPEF)、呼气不均匀指数(ΔEDI)和吸气峰流量(ΔPIF)的总体平均差异分别为 2.26 L/s(95% CI 2.14-2.38)、27.94 s(95% CI 26.36-29.52)和 1.21 L/s(95% CI 0.95-1.47)。ΔPEF 和 ΔPIF 值增加,而 ΔEDI 值降低。在预测是否需要手术干预方面,EDI 的敏感性最高(88%),而一秒用力呼气量/用力肺活量的特异性最高(85%)。

结论

肺功能是评估 LTS 患者的有用工具。PEF、EDI 和 PIF 是最常报道的肺功能参数,在气道狭窄缓解后显著改善。

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