甲状腺切除术中能量器械的比较有效性与安全性：一项基于结局的随机对照试验网络荟萃分析
Comparative Effectiveness and Safety of Energy Devices for Thyroidectomy: An Outcome-Specific Network Meta-Analysis of Randomized Controlled Trials.
文献信息
| PMID | 42947529 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Do Hyun Kim |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. |
| 期刊 | Head & neck |
| SCI 分区 | Q1 |
| IF | 2.5 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 我们进行了一项基于结局的网络荟萃分析，比较甲状腺切除术中当代能量器械。
方法： 纳入比较传统止血与Harmonic、LigaSure、Thunderbeat或其他先进能量器械在甲状腺切除术中的随机对照试验。按结局进行频率学派随机效应网络荟萃分析，采用P评分对治疗排序，并通过设计-治疗交互和节点拆分分析评估一致性。
结果： 与传统止血相比，Harmonic显著缩短手术时间（SMD，-1.88）、减少失血量（SMD，-2.29）、引流量（SMD，-1.77）、住院时间（SMD，-0.74）、暂时性低钙血症（OR，0.61）、暂时性喉返神经麻痹（OR，0.63）和术后出血（OR，0.56）。LigaSure改善了手术效率，但恢复和安全性获益的一致性较低。Harmonic在大多数结局中排名最高。
结论： 在所评估的结局中，Harmonic显示出最有利的相对效应。然而，这些发现并未确立器械的总体优越性；选择应考虑绝对获益和器械特异性特征。
英文摘要
BACKGROUND: We performed an outcome-specific network meta-analysis comparing contemporary energy devices in thyroidectomy.
METHODS: Randomized controlled trials comparing conventional hemostasis with Harmonic, LigaSure, Thunderbeat, or other advanced energy devices during thyroidectomy were included. Frequentist random-effects network meta-analyses were performed per outcome, with treatments ranked by P-scores and consistency assessed via design-by-treatment interaction and node-splitting analyses.
RESULTS: Compared to conventional hemostasis, Harmonic significantly reduced operative time (SMD, -1.88), blood loss (SMD, -2.29), drainage volume (SMD, -1.77), hospital stay (SMD, -0.74), transient hypocalcemia (OR, 0.61), transient recurrent laryngeal nerve palsy (OR, 0.63), and postoperative bleeding (OR, 0.56). LigaSure improved operative efficiency but showed less consistent recovery and safety benefits. Harmonic ranked highest across most outcomes.
CONCLUSIONS: Harmonic showed the most favorable relative effects across the evaluated outcomes. However, these findings do not establish overall device superiority; selection should consider absolute benefits and device-specific characteristics.