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T1a声门型喉癌患者激光和放射治疗后嗓音功能评估文献的Meta分析

A Comparative Assessment of Voice after Laser Surgery Versus Radiotherapy of T1a Glottic Carcinoma:A Meta-Analysis

黄冠江;罗梦思;张靖萱;朱财明;刘建国;刘红兵;

1:南昌大学第二附属医院耳鼻咽喉头颈外科

2:南昌大学第二附属医院麻醉科

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摘要

目的通过对相关文献的Meta分析,评估T1a声门型喉癌患者激光手术和放射治疗后的嗓音功能。方法通过计算机检索PubMed、Web of Science、Embase数据库、Cochrane library、中国知网数据库及万方数据库从创建到2016年10月的文献数据,纳入比较T1a声门型喉癌患者激光手术和放射治疗后的嗓音功能评估随机对照研究和队列研究文献,由两位共同作者同时对搜索的相关文献进行阅读和筛选,从中提取与研究目的相关的数据,用Review Manager 5.3软件进行Meta分析,分析和比较两种方式治疗后患者VHI评分、最长发声时间(MPT)、基频(F0)、基频微扰(jitter)、振幅微扰(shimmer)、气流量(AFR)。结果共检索相关文献182篇,共纳入符合要求的文献14篇,均为队列研究,共有716例患者,其中行激光手术的患者391例,行放射治疗患者325例。Meta分析结果表明,激光手术组患者术后最长发声时间(MPT)比放射治疗组短[总效应Z=2.65,MD=-2.26,95%CI(-3.94,-0.59),P=0.008],基频(F0)较放射治疗组低[总效应Z=7.49,MD=14.41,95%CI(10.14,18.19),P<0.00 001],两种方式治疗后患者的VHI评分[总效应Z=1.04,MD=5.86,95%CI(-5.22,16.94),P=0.30]、jitter[总效应Z=1.43,MD=0.75,95%CI(-0.28,1.79),P=0.15]、shimmer[总效应Z=1.26,MD=1.07,95%CI(-0.60,2.75,P=0.21]及AFR[总效应Z=0.42,MD=21.46,95%CI(-78.79,121.72),P=0.67]差异均无统计学意义。结论在保护T1a声门型喉癌患者嗓音功能(MPT、F0)方面放射治疗稍优于激光手术,但两种方式治疗后患者嗓音障碍指数量表、基频微扰、振幅微扰及气流量差异均无统计学意义。

关键词

激光;放射治疗;声门型喉癌;Meta分析

基金项目(Foundation):

作者

黄冠江;罗梦思;张靖萱;朱财明;刘建国;刘红兵;

参考文献

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