Tla声门型喉癌经激光手术与放射治疗后嗓音质量的系统综述和Meta分析

发布时间：2019-06-25 00:24

【摘要】：目的:通过系统综述和meta分析评估T1a声门型喉癌经激光手术和放射治疗后的嗓音质量。方法:通过计算机检索PubMed、Web of Science、Embase数据库、Cochrane、中国生物文献数据库(CBM)、相关期刊论文(CNKI)、万方数字期刊全文数据库等,从创建到2016年10月31日的文献数据,纳入比较T1a声门型喉癌经激光手术和放射治疗后的嗓音功能的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,然后对提取的数据用Review Manager 5.3软件进行meta分析,分析和比较两种治疗方式后嗓音障碍指数(VHI)、最大发音时间(MPT),基频(F0),基频微扰(Jitter),振幅微扰(Shimmer),气流量(AFR)。结果:通过文献检索和筛选结果共纳入符合要求的文献15篇,其中1篇随机对照研究,1篇前瞻性研究,13篇回顾性研究。系统综述和meta分析结果表明,激光手术组比放射治疗组最大发音时间(MPT)短[MD=-2.26,95%CI(-3.94,-0.59),P=0.008],基频(F0)高[MD=14.41,95%CI(10.14,18.19),P0.00001],两种治疗方式后嗓音障碍指数量表(VHI)[MD=5.86,95%CI(-5.22,16.94),P=0.30],基频微扰(Jitter)[MD=0.75,95%CI(-0.28,1.79),P=0.15],振幅微扰(Shimmer)[MD=1.07,95%CI(-0.60,2.75,P=0.21]、气流量(AFR)[MD=21.46,95%CI(-78.79,121.72),P=0.67]以及GRBAS评估差异均无明显统计学意义。结论:在对T1a声门型喉癌患者治疗中,放射治疗在MPT和F0方面稍优于激光手术,但嗓音障碍指数量表(VHI)、基频微扰(Jitter)、振幅微扰(Shimmer)、气流量(AFR)以及GRBAS评估差异均无明显统计学意义。因此,迫切需要更多的多中心的随机对照试验来验证这个结论。
[Abstract]:Objective: to evaluate the voice quality of T1a glottic carcinoma after laser surgery and radiotherapy by systematic review and meta analysis. Methods: the PubMed,Web of Science,Embase database was searched by computer, and the Cochrane, Chinese biological literature database (CBM), Chinese journal full-text database (CNKI), Wanfang digital journal full-text database was searched. From the establishment to October 31, 2016, the literature data were included in the randomized controlled study and cohort study to compare the voice function of T1a glottic carcinoma after laser surgery and radiotherapy. The related literature was read and screened by the two co-authors at the same time, and the data related to the purpose of the study were extracted, and then the extracted data were analyzed by meta with Review Manager 5.3 software. The (VHI), maximum pronunciation time (MPT), fundamental frequency (F0) and the fundamental frequency perturbation (Jitter), amplitude perturbation (Shimmer), air flow (AFR). After the two treatments were analyzed and compared. Results: a total of 15 literatures were included in the literature retrieval and screening results, including 1 randomized controlled study, 1 prospective study and 13 retrospective studies. The results of systematic review and meta analysis showed that the maximum pronunciation time (MPT) in the laser operation group was shorter than that in the radiotherapy group [MD=-2.26,95%CI (- 3.94, 0.59), P 鈮，

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