单纯腺样体切除术治疗儿童分泌性中耳炎的荟萃分析
| 作者: |
1,2朱增辉,
2张芳芳,
1刘稳,
1神平,
1张伟强,
1仝悦,
1王川
1 徐州医科大学附属医院耳鼻喉科，江苏 徐州 221006 2 枣庄市妇幼保健院儿科，山东 枣庄 277100 |
| 通讯: |
刘稳
Email: Liuwen1972@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.09.029 |
摘要
目的：评价单纯腺样体切除术与腺样体切除术+鼓膜切开置管治疗儿童分泌性中耳炎(otitis media with effusion，OME)的有效性和安全性，为选择最佳手术方式提供循证参考。方法：采用荟萃分析的方法，在中国知网、万方、维普、Medline、PubMed等数据库检索1999至2020年纳入有关单纯腺样体切除术、腺样体切除术+鼓膜切开置管术治疗儿童OME的随机对照研究(randomized controlled trials，RCT)，经2位研究者独立进行文献筛选、资料提取和方法学质量评价后，采用RevMan 5.3软件进行荟萃分析。结果：经检索和筛选，共纳入11个RCT试验进行研究。荟萃分析结果显示：腺样体切除术+鼓膜切开置管术治疗儿童OME的有效性优于单纯腺样体切除术(OR=0.27，95%CI：0.14~0.52，Z=3.92，P<0.05)，两种手术方式治疗儿童OME引起的并发症和复发率差异无统计学意义(OR=1.09，95%CI：0.45~2.63，Z=0.19，P>0.05)。结论：伴有腺样体肥大的OME患儿，单纯腺样体切除治疗儿童OME有一定疗效，但目前最佳手术方式仍为腺样体切除术+鼓膜置管术。
关键词：
儿童分泌性中耳炎；腺样体切除术；鼓膜切开置管术
Treatment of adenoidectomy for otitis media with effusion in children: A Meta-analysis
CorrespondingAuthor: LIU Wen Email: Liuwen1972@163.com
DOI: 10.3978/j.issn.2095-6959.2021.09.029
Abstract
Objective: To evaluate the efficacy and safety of adenoidectomy and adenoidectomy combined with tympanotomy-tube in the treatment of otitis media with effusion (OME) in children by this Meta-analysis, so as to provide an evidence-based reference for selecting the best surgical method. Methods: The randomized controlled trials (RCT) about adenoidectomy and adenoidectomy combined with tympanotomy tube for the treatment of OME in children from 1999 to 2020 were searched in CNKI, Wanfang Database, VIP, PubMed, Medline, and so on. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality, and Meta-analysis was performed by RevMan 5.3 software. Results: After rigorous retrieval and screening, a total of 11 randomized controlled trials were included in this study. Adenoidectomy combined with tympanotomy-tube for the treatment of OME in children was more effective than adenoidectomy (OR=0.26, 95%CI: 0.14–0.51, Z=3.92, P<0.05). There was no significant difference between the two surgical methods in the treatment of OME with complications and recurrence rates (OR=1.09, 95%CI: 0.45–2.63, Z=0.19, P>0.05). Conclusion: Although adenoidectomy has a certain availability in the treatment of OME in children with adenoidal hypertrophy, the best surgical method is still adenoidectomy combined with tympanotomy tube.
Keywords：
otitis media with effusion in children; adenoidectomy; tympanotomy-tube