等离子扁桃体切除术与常规扁桃体剥离术术后出血的Meta分析

目的比较等离子扁桃体切除术与常规扁桃体剥离术术后出血情况。方法计算机检索Science direct、Cochrane li-brary、MEDLINE、EMbase、CNKI、VIP、CBM、万方数字图书馆等数据库等,并辅以手工检索相关会议论文集、设备厂商资料及所有检索到的文献。收集比较两种手术方法的文献,由两名研究者评价纳入研究的方法学质量,扁桃体切除术作为试验组,常规扁桃体剥离术作为对照组,提取有效的数据进行分析。结果共有11篇文献符合纳入标准,其中,随机对照试验7篇,前瞻性队列研究3篇,病例对照研究1篇,分析得出试验组术后出血率为6.49%,对照组为3.28%。剔除方法学评分较低的研究(3篇),进行Meta分析,试验组出血发生率为5.58%,对照组为4.30%,两组差异无统计学意义(OR:1.36,95%CI:0.60～3.04,Z=0.74,P=0.46);试验组继发性出血发生率为5.20%,对照组为3.94%,两组差异无统计学意义(OR:1.53,95%CI:0.65～3.59,Z=0.98,P=0.32)。结论等离子扁桃体切除术与常规扁桃体剥离术术后出血发生率的比较无差别,由于等离子扁桃体切除术在其他方面已经证实了具有明显的优势,值得在临床广泛推广。

Meta-analyis of postoperative hemorrhage following coblation tonsillectomy and traditional tonsillectomy

Objective To systematically compare postoperative hemorrhage between coblation tonsillectomy and traditional tonsillectomy.Methods Elsevier Science Direct,Cochrane Library,Medline,Embase,CNKI,VIP,CBM,and Wanfang Data were searched by computer,supplemented relevant conference proceedings,equipment manufacturers and reference lists of all literature by manual retrieval.All the literatures about the two operation methods were compared.Coblation tonsillectomy and traditional tonsillectomy were considered as the treatment group and the control group,respectively.The quality of the methodology was eveluated by two independent observers.The efficient data were Abstracted and statistically analyzed.Results Eleven trials were identified,including seven randomized controlled trials,three prospective cohort studys and one case-control study.The statistical analysis result was that the postoperative hemorrhage rate of the treatment group and the control group were 6.49% and 3.28%,respectively.By eliminating 3 trails with lower scores in methodology,the postoperative hemorrhage of treatment group and control group were 5.58%and 4.30%,respectively.Meta analysis was conducted to analyze odds ratio(OR) and 95% confidence interval(CI),no statistical difference in the postoperative hemorrhage was demonstrated(OR:1.36,95%CI:0.60-3.04,Z=0.74,P=0.46).The secondary hemorrhage of treatment group and control group were 5.20% and 3.94%,respectively,with no statistical difference(OR:1.36,95%CI:0.60-3.04,Z=0.74,P=0.46).Conclusion There was no difference in the rate of postoperative hemorrhage in the patients undergoing coblation tonsillectomy and traditional tonsillectomy.Coblation tonsillectomy has obvious advantages proved in other respects,So is worth exploring in clinic.