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doi:10.3760/cma.j.cn115909-20210303-00086

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摘要目的：系统评价早期鼻内窥镜下泪囊鼻腔吻合术（EEN-DCR）和晚期泪囊鼻腔吻合术（L-DCR）治疗急性泪囊炎的临床有效性和安全性。方法：文献研究。由2位评审人员用计算机检索CNKI、万方、维普、PubMed、Cochrane 等数据库中2000年1月～2021年1月有关EEN-DCR治疗急性泪囊炎的中英文相关文献，做独立文献筛查、质量评价并进行资料提取及整理。根据L-DCR组手术方式的不同又分为晚期鼻内窥镜下鼻腔泪囊吻合术（LEN-DCR）组和晚期外路鼻腔泪囊吻合（LEX-DCR）组。采用RevMan 5.3.3软件完成Meta分析。结果：最终纳入6篇文献，共325例，其中EEN-DCR组177例和L-DCR组148例。Meta分析结果显示，在治愈率方面，EEN-DCR组和L-DCR组比较差异无统计学意义[OR=1.44（95%CI：0.78～2.65），P=0.34，I2=12%]；亚组分析显示EEN-DCR分别与LEN-DCR、LEX-DCR比较差异均无统计学意义[OR=0.98（95%CI：0.40～2.42），P=0.96，I2=0%；OR=2.03（95%CI：0.86～4.78），P=0.11，I2=50%]。EEN-DCR和L-DCR在复发率方面无明显差异和异质性[OR=0.29（95%CI：0.03～2.86），P=0.29，I2=0%]。然而在症状缓解时间上，与L-DCR组相比，EEN-DCR组花费的时间更少[MD=-9.51（95%CI：-14.65～-4.37），P=0.0003，I2=42%]。结论：EEN-DCR治疗急性泪囊炎与L-DCR的疗效相似，但前者所需的症状缓解时间更少，这既可以增加患者的舒适度也可以降低经济成本。

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关键词 ：早期鼻内窥镜下鼻腔泪囊吻合术, 晚期泪囊鼻腔吻合术, 急性泪囊炎, Meta分析

Abstract：Objective: To estimate the clinical efficacy and safety of early endoscopic dacryocystorhinostomy (EENDCR) and late dacryocystorhinostomy (L-DCR) for the treatment of acute dacryocystitis via meta-an alysis. Methods: This is a literature search. Relevant articles published in English and Chinese from January 2000 and the Cochrane Library databases. After that, two researchers extracted data and independently assessed the quality of the articles. Data were divided into the comparison of EEN-DCR and late endoscopic dacryocystorhinostomy (LEN-DCR) as well as EEN-DCR and late external dacryocystorhinostomy (LEXDCR) according to different L-DCRs. RevMan 5.3 software was used to perform meta-analysis. Results:A total of 6 articles involving 325 subjects were included, consisting of 177 cases in the EEN-DCR group and 148 cases in the L-DCR group. Meta-analysis showed that there was no significant difference in the prevalence of anatomic and functional success between EEN-DCR and L-DCR [OR=1.44(95%CI: 0.78-2.65), P=0.34, I2=12%] and no significant difference was found between the 2 subgroups [OR=0.98(95%CI: 0.40-2.42), P=0.96, I2=0% and OR=2.03(95%CI: 0.86-4.78), P=0.11, I2=50%]. Similarly, there were no significant differences in terms of the recurrence rate or heterogeneity between EEN-DCR and L-DCR for the treatment of acute dacryocystitis [OR=0.29(95%CI: 0.03-2.86), P=0.29, I2 =0%]. However, symptom resolution was shorter for EEN-DCR compared with L-DCR [MD=-9.51(95%CI: -14.65- -4.37), P=0.0003, I2=42%]. Conclusions: The efficacy of EEN-DCR is similar to that of L-DCR for the treatment of acute dacryocystitis. However, the former has a shorter time for symptom resolution, which is beneficial for enhancing patients' comfort and decreasing economic cost.

Key words： early endoscopic dacryocystorhinostomy late dacryocystorhinostomy acute dacryocystitis meta-analysis

收稿日期: 2021-03-03

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通讯作者: 赵军（ ORCID： 0000-0002-8997-2046）， Email： zhaojunyy@sina.com

引用本文:

倪淑华郑凌方许莞菁赵爽赵军. 早期鼻内窥镜下泪囊鼻腔吻合术对急性泪囊炎临床效果的Meta分析
[J]. 中华眼视光学与视觉科学杂志, 2021, 23(10): 781-787. Shuhua Ni, Lingfang Zheng, Wanjing Xu, Shuang Zhao, Jun Zhao. The Clinical Efficacy of Early Endoscopic Dacryocystorhinostomy for the Treatment of Acute Dacryocystitis: Meta-Analysis. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(10): 781-787. DOI: 10.3760/cma.j.cn115909-20210303-00086

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20210303-00086 或 https://www.cjoovs.com/CN/Y2021/V23/I10/781

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