乳突病变切除加鼓室成形术与单纯鼓室成形术治疗中耳炎疗效的Meta分析

Comparison the Effect of Mastoidectomy with Tympanoplasty and Tympanoplasty Alone on the Treatment of Chronic Suppurative Otitis Media:A Meta-Analysis

方敏;杨贵军;李朝军;杨莉;邝邵景;莫海兰;

1:重庆市第三人民医院耳鼻咽喉头颈外科

2:四川省江油市人民医院耳鼻咽喉科

摘要
目的比较乳突病变切除加鼓室成形术与单纯鼓室成形术治疗慢性化脓性中耳炎的疗效。方法通过计算机检索Pubmed、Embase、OVID、Cochrane library、中国知网数据库和万方数据库创建到2015年1月的文献数据,纳入比较乳突病变切除加鼓室成形术与单纯鼓室成形术治疗慢性化脓性中耳炎的随机对照研究和队列研究文献,采用RevMan5.2软件包对纳入文献进行Meta分析,分析两种术式的鼓膜修补愈合率、气导和骨导听阈。结果共检索到13篇符合纳入标准的文献,其中5篇随机对照研究,8篇队列研究;总患病耳数为2 136耳,行乳突病变切除加鼓室成形术812耳,行单纯鼓室成形术1 324耳。两种手术方式的鼓膜愈合率分别为87.11%(696/799)和87.55%(1 139/1 301),差异无统计学意义[RR=1.02,95%CI(0.99,1.06),P=0.20];两种术式患者术后气骨导差≤20dB的耳数分别占79.42%(328/413)和79.17%(475/600),差异无统计学意义[RR=0.99,95%CI(0.93,1.06),P=0.76];两种术式术后气导平均听阈改善差异无统计学意义[SMD=-0.01,95%CI(-0.29,0.31),P=0.93]。结论治疗乳突感染已被良好控制、非活动期但鼓室长期潮湿、中耳黏膜增厚的慢性化脓性中耳炎,乳突病变切除不能提高鼓室成形术后鼓膜愈合率,也不会影响鼓室成形术后听力提高程度。
关键词
乳突切除;鼓室成形;慢性化脓性中耳炎
基金项目(Foundation):
重庆市医学科研项目资助(2011-1-100)
作者
方敏;杨贵军;李朝军;杨莉;邝邵景;莫海兰;
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