内镜鼻窦手术治疗变应性真菌性鼻窦炎的疗效：一项系统评价与Meta分析。
Efficacy of Endoscopic Sinus Surgery for Allergic Fungal Rhinosinusitis: A Systematic Review With Meta-analysis.
文献信息
| PMID | 42765459 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Amani Kais |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 内镜鼻窦手术（ESS）在变应性真菌性鼻窦炎（AFRS）的管理中发挥核心作用；然而，不同研究的结果存在差异。本研究旨在系统评价并综合ESS治疗AFRS患者结局的证据。
数据来源： PubMed、Scopus、Web of Science和Cochrane对照试验中心注册库。
综述方法： 按照系统评价和Meta分析首选报告条目（PRISMA）指南，对从建库至2025年10月的文献进行了系统检索。纳入报告AFRS患者ESS术后结局和复发的研究。
结果： 共分析31项研究，涵盖1474例AFRS患者。随访时间为1.5至32.5个月（平均=13.7个月），术后药物治疗存在显著差异。总体疾病复发率为31%（95% CI，25%-38%），合并ESS修正手术率为19%（95% CI，14%-25%）。ESS显著改善鼻窦生活质量，22项鼻窦结局测试（SNOT-22）评分合并降低23.37分（95% CI，18.71-28.02）。术后口服伊曲康唑使用与较低的复发率无关（30.7% vs 31.1%，P=0.957），也与较低的手术修正率无关（18.2% vs 20.3%，P=0.643）。
结论： ESS可显著改善AFRS患者术后生活质量，总体复发率为31%，手术修正率为19%。需要进一步高质量研究来确定最佳术后辅助治疗，以减少复发并改善长期结局。
英文摘要
OBJECTIVE: Endoscopic sinus surgery (ESS) plays a central role in the management of allergic fungal rhinosinusitis (AFRS); however, outcomes vary across studies. The goal of this study is to systematically review and synthesize evidence on the outcomes of ESS in patients with AFRS.
DATA SOURCES: PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials.
REVIEW METHODS: A systematic search of the literature was conducted from inception to October 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies reporting postoperative outcomes and recurrence following ESS in AFRS were included.
RESULTS: Thirty-one studies encompassing 1474 AFRS patients were analyzed. Follow-up durations ranged from 1.5 to 32.5 months (mean = 13.7 months), with substantial variability in postoperative medical therapy. The overall disease recurrence rate was 31% (95% CI, 25%-38%), and the pooled ESS revision rate was 19% (95% CI, 14%-25%). ESS significantly improved sinonasal quality of life, with a pooled reduction in 22-item sinonasal outcome test (SNOT-22) score of 23.37 points (95% CI, 18.71-28.02). Postoperative oral itraconazole use was not associated with a lower recurrence rate (30.7% vs 31.1%, P = .957), nor a lower surgical revision rate (18.2% vs 20.3%, P = .643).
CONCLUSION: ESS substantially improves postoperative quality of life in AFRS, with an overall recurrence rate of 31% and surgical revision rate of 19%. Further high-quality studies are needed to define optimal postoperative adjuvant therapy to minimize recurrence and enhance long-term outcomes.