【摘要】：目的通過(guò)對(duì)相關(guān)文獻(xiàn)的Meta分析,評(píng)估T1a聲門(mén)型喉癌患者激光手術(shù)和放射治療后的嗓音功能。方法通過(guò)計(jì)算機(jī)檢索PubMed、Web of Science、Embase數(shù)據(jù)庫(kù)、Cochrane library、中國(guó)知網(wǎng)數(shù)據(jù)庫(kù)及萬(wàn)方數(shù)據(jù)庫(kù)從創(chuàng)建到2016年10月的文獻(xiàn)數(shù)據(jù),納入比較T1a聲門(mén)型喉癌患者激光手術(shù)和放射治療后的嗓音功能評(píng)估隨機(jī)對(duì)照研究和隊(duì)列研究文獻(xiàn),由兩位共同作者同時(shí)對(duì)搜索的相關(guān)文獻(xiàn)進(jìn)行閱讀和篩選,從中提取與研究目的相關(guān)的數(shù)據(jù),用Review Manager 5.3軟件進(jìn)行Meta分析,分析和比較兩種方式治療后患者VHI評(píng)分、最長(zhǎng)發(fā)聲時(shí)間(MPT)、基頻(F0)、基頻微擾(jitter)、振幅微擾(shimmer)、氣流量(AFR)。結(jié)果共檢索相關(guān)文獻(xiàn)182篇,共納入符合要求的文獻(xiàn)14篇,均為隊(duì)列研究,共有716例患者,其中行激光手術(shù)的患者391例,行放射治療患者325例。Meta分析結(jié)果表明,激光手術(shù)組患者術(shù)后最長(zhǎng)發(fā)聲時(shí)間(MPT)比放射治療組短[總效應(yīng)Z=2.65,MD=-2.26,95%CI(-3.94,-0.59),P=0.008],基頻(F0)較放射治療組低[總效應(yīng)Z=7.49,MD=14.41,95%CI(10.14,18.19),P0.00 001],兩種方式治療后患者的VHI評(píng)分[總效應(yīng)Z=1.04,MD=5.86,95%CI(-5.22,16.94),P=0.30]、jitter[總效應(yīng)Z=1.43,MD=0.75,95%CI(-0.28,1.79),P=0.15]、shimmer[總效應(yīng)Z=1.26,MD=1.07,95%CI(-0.60,2.75,P=0.21]及AFR[總效應(yīng)Z=0.42,MD=21.46,95%CI(-78.79,121.72),P=0.67]差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論在保護(hù)T1a聲門(mén)型喉癌患者嗓音功能(MPT、F0)方面放射治療稍?xún)?yōu)于激光手術(shù),但兩種方式治療后患者嗓音障礙指數(shù)量表、基頻微擾、振幅微擾及氣流量差異均無(wú)統(tǒng)計(jì)學(xué)意義。
[Abstract]:Objective to evaluate the voice function of patients with T 1a glottic carcinoma after laser surgery and radiotherapy by Meta analysis. Methods the PubMed,Web of Science,Embase database, Cochrane library, and Wanfang database were retrieved by computer from their founding to October 2016. A randomized controlled study and cohort study on the evaluation of voice function in patients with T1a glottic carcinoma after laser surgery and radiotherapy were included. The two co-authors simultaneously read and screened the searched literature. The data related to the purpose of the study were extracted, and the Meta analysis was carried out with Review Manager 5.3 software. The VHI score, (MPT), base frequency (F0), and perturbation (jitter), were analyzed and compared between the two methods after treatment. Amplitude perturbation (shimmer), gas flow (AFR). Results A total of 182 articles were retrieved, and 14 articles were included in the cohort study. A total of 716 patients, including 391 patients undergoing laser surgery and 325 patients undergoing radiotherapy, were included in the cohort study. The results of Meta analysis showed that: 1. The longest postoperative phonation time (MPT) in laser operation group was shorter than that in radiotherapy group [total effect Z2.65 MD-2.2695 CI (-3.94 鹵-0.59), P0. 008], and the fundamental frequency (F0) was lower than that in radiotherapy group [total effect Z0 7.49]. MD=14.41,95%CI (10.14 鹵18.19), P0.00001, VHI score of patients after two kinds of treatment [total effect ZH1.04Md 5.86mg / 95CI (-5.221.94), P0.30], jitter [total effect ZH1.43, total effect ZN 1.43, P < 0.05]. MD=0.75,95%CI (-0.28 鹵1.79), P0. 15], shimmer [total effect Z _ (1.26) Md ~ (1.07) ~ (95) CI (-0.60 ~ 2.75) P ~ (0.21)] and AFR [total effect Z _ (0.42) M D ~ (21.46) ~ (95) CI (-78.79121.72), There was no significant difference in P0. 67]. Conclusion radiation therapy is better than laser surgery in protecting voice function (MPT,F0) of patients with T1a glottic carcinoma. There was no significant difference in amplitude perturbation and gas flow.
【作者單位】： 南昌大學(xué)第二附屬醫(yī)院耳鼻咽喉頭頸外科;南昌大學(xué)第二附屬醫(yī)院麻醉科;
【分類(lèi)號(hào)】：R739.65

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