经鼻内镜眼眶减压术治疗Graves眼病的Meta分析
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南京医科大学第一附属医院临床诊疗新技术新项目;江苏省卫生厅科研基金项目(H200904)


A Meta analysis of the efficacy and safety of endoscopic orbital decompression for Graves’ ophthalmopathy
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    目的:系统评价经鼻内镜眼眶减压术治疗Graves眼病的有效性和安全性-方法:检索Medline-Cochrane 图书馆临床对照试验资料库中有关经鼻内镜眼眶减压术的随机对照试验或自身对照试验,时限均从建库至2013年5月,并对所获文献的参考文献进行回溯性检索和引文检索-由2位研究者按纳入与排除标准独立进行文献筛选-资料提取和质量评价后,采用 RevMan 5.1.0 软件进行Meta 分析-结果:最终纳入5个自身对照试验,共156例患者-Meta 分析结果显示经鼻内镜眼眶内下壁减压术后眼眶突出程度均较术前明显降低,但视力及复视发生率无明显改变-敏感性分析显示本研究结果较稳定-结论:经鼻内镜眼眶减压术可以显著改善Graves眼病的视功能,且引起术后新发复视危险较小-但此结论需进一步由高质量大样本长期随机对照的临床试验来验证-

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    Objective:To assess the efficacy and safety of endoscopic orbital decompression systematically in treating Graves’ ophthalmopathy. Methods:Databases included the Cochrane Central Register of Controlled Trials,Medline from their inception to May,2013,and the relevant journals and references of articles were also retrospectively searched to collect randomized controlled trials (RCTs) or before-after self-controlled trials on endoscopic orbital decompression. Two reviewers independently screened the articles according to the predefined inclusive and exclusive criteria,and then extracted necessary data and evaluated quality of the included studies. Then meta-analysis were performed using RevMan 5.1.0. Results:A total of the 5 self-controlled trials involving 156 patients were finally included. The results of meta-analysis showed a significant reduction in proptosis without marked change in diplopia. However, the sight and the incidence of diplopia did not change significantly. Sensitivity analysis indicated that these results were stable. Conclusion:Endoscopic orbital decompression improved proptosis and ophthalmological function in Graves ophthalmothy. There is no evidence that endoscopic orbital decompression could increase the risk of new upset diplopia. However,prospective RCTs with larger scale and longer follow-up are still necessary to confirm this conclusion.

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姚 蒙,殷 敏,程 雷.经鼻内镜眼眶减压术治疗Graves眼病的Meta分析[J].南京医科大学学报(自然科学版),2014,(9):1284,1288-1292

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  • 收稿日期:2014-03-09
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  • 在线发布日期: 2014-09-11
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