声带良性病变患者的类固醇注射：一项荟萃分析与荟萃回归。
Steroid Injection in Patients With Benign Vocal Fold Lesions: A Meta-Analysis and Meta-Regression.
文献信息
| PMID | 42812590 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yousef M Al-Shammari |
| 作者单位 | Ophthalmology Department AlBahar Ophthalmology Center, Ibn Sina Hospital, Ministry of Health Kuwait City Kuwait. |
| 期刊 | OTO open |
| SCI 分区 | Q2 |
| IF | 1.7 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 本研究旨在评估类固醇注射在声带良性病变患者中的疗效与安全性。
数据来源： 检索了PubMed、Scopus和Embase，时间范围为2000年1月至2025年12月，使用针对声带良性病变和类固醇注射的预设检索词。
综述方法： 我们开展了一项遵循PRISMA指南的系统综述和荟萃分析，纳入评估类固醇注射治疗声带良性病变的研究。研究筛选和数据提取由两名评价者独立完成。研究质量分别采用NIH（队列研究）、JBI（病例系列）和RoB 2（随机对照试验）进行评估。在OpenMeta[Analyst]中采用随机效应荟萃分析（DerSimonian-Laird法），对比例结局使用Freeman-Tukey双反正弦变换。
结果： 共纳入14项研究。治疗后VHI合并均值为17.585（95% CI 10.61-24.55；I² = 97%），而VHI变化无统计学显著性（-6.948；95% CI -16.06至2.16；I² = 98%），表明研究间存在显著异质性，且合并VHI效应估计的确定性有限。MPT改善，治疗后合并均值为13.24秒（95% CI 12.54-13.94；I² = 73%），合并变化为1.81秒（95% CI 1.10-2.52；I² = 71%）。并发症不常见（1.5%；I² = 0%）。总体改善率为92%，复发率为15.2%，完全缓解率为42.5%，部分缓解率为39.6%，无应答率为9.4%。
结论： 类固醇注射与较高的临床改善率和较低的并发症率相关。然而，VHI显示出显著异质性，且各研究间统计学显著性不一致，限制了合并生活质量估计的稳健性和可推广性。这些发现支持将类固醇注射作为特定患者的一种微创选择，但强调需要标准化方案和更高质量的对照试验，以更好地明确其对患者报告嗓音结局的影响。
英文摘要
OBJECTIVES: This study aims to assess the efficacy and safety of steroid injections in patients with benign vocal fold lesions.
DATA SOURCES: PubMed, Scopus, and Embase were searched from January 2000 through December 2025 using predefined terms for benign vocal fold pathology and steroid injection.
REVIEW METHODS: We conducted a PRISMA-guided systematic review and meta-analysis of studies evaluating steroid injections for benign vocal fold lesions. Study selection and data extraction were performed independently by two reviewers. Study quality was assessed using NIH (cohort studies), JBI (case series), and RoB 2 (RCTs). Random-effects meta-analysis (DerSimonian-Laird) was performed in OpenMeta[Analyst], with Freeman-Tukey double arcsine transformation for proportional outcomes.
RESULTS: Fourteen studies were included. Posttreatment VHI pooled mean was 17.585 (95% CI 10.61-24.55; I 2 = 97%), while VHI change was not statistically significant (-6.948; 95% CI -16.06 to 2.16; I 2 = 98%), indicating substantial between-study heterogeneity and limited certainty in pooled VHI effect estimates. MPT improved, with post-treatment pooled mean 13.24 seconds (95% CI 12.54-13.94; I 2 = 73%) and pooled change 1.81 seconds (95% CI 1.10-2.52; I 2 = 71%). Complications were uncommon (1.5%; I 2 = 0%). Overall improvement was 92%, recurrence 15.2%, complete remission 42.5%, partial remission 39.6%, and no response 9.4%.
CONCLUSION: Steroid injection was associated with high clinical improvement and low complication rates. However, VHI demonstrated substantial heterogeneity and inconsistent statistical significance across studies, limiting the robustness and generalizability of pooled quality-of-life estimates. These findings support steroid injection as a minimally invasive option in selected patients but highlight the need for standardized protocols and higher-quality comparative trials to better define its effect on patient-reported voice outcomes.