下鼻甲手术的循证研究

目的用循证医学方法寻找下鼻甲手术的最佳术式。方法用MEDLINE检索近50 a间涉及下鼻甲手术各种术式的文献,并对文献进行分类。结果共检出文献1 587篇,其中对下鼻甲手术进行详细介绍的文献679篇;近30 a有关下鼻甲激光手术和内镜手术的文献有增多趋势;未检出治疗鼻塞的下鼻甲手术的随机对照试验;最高循证等级为Ⅲ级,仅作为B级推荐;支持术式疗效的证据还不充分。结论下鼻甲手术方式的选择似乎是受技术进步的驱动,而不是为了有益于患者需要;应适当进行随机对照试验从常用的方法中找出长期有益于患者的方法。

Evidence-based medicine of inferior turbinate surgery

Objective To explore the best surgical method for inferior turbinate by evidence-based medicine.Methods A MEDLINE search was used to identify articles involving all forms inferior turbinate surgery over a 50-year period,then these papers were divided into different series under main headings.Results One thousand five hundred and eighty-seven papers were identified.Of these,six hundred and seventy-nine papers specifically detailed inferior turbinate surgery.The number of papers about endoscopic and laser inferior turbinate surgery in the last 30 years showed increasing tendency.No randomized controlled trials were identified describing inferior turbinate surgery for nasal obstruction.The highest levels of evidence identified were level Ⅲ(grade B) articles.The evidence supporting the efficacy of these procedures remains debatable.Conclusion The choose of surgical method of inferior turbinate seems to be driven by technological advancement rather than by establishment of patient benefit.Conducted randomized controlled trials should be established to find the long-term and beneficial methods for patients from these commonly performed operations.