鼻中隔贯穿缝合与鼻内夹板固定用于鼻中隔成形术后的比较：系统评价与荟萃分析

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中文摘要

目的： 通过系统评价与荟萃分析比较鼻中隔成形术后鼻中隔贯穿缝合与鼻内夹板固定的有效性和安全性，重点关注术后并发症和以患者为中心的结局。
方法： 纳入直接评估两种技术的比较性研究。计算合并比值比和标准化均数差及其95%置信区间。
结果： 共纳入17项研究，涉及1502例患者。在粘连、结痂形成、鼻中隔血肿、鼻中隔穿孔或术后出血方面未发现显著差异。鼻中隔贯穿缝合显著减轻术后疼痛（标准化均数差，-1.09；95%置信区间，-1.68至-0.49）和睡眠障碍（标准化均数差，-0.32；95%置信区间，-0.60至-0.05），但延长手术时间（标准化均数差，0.65；95%置信区间，0.19-1.10）。鼻中隔贯穿缝合组感染和泪溢的发生率趋于更低。
结论： 两种技术对主要术后并发症的保护作用相当，但鼻中隔贯穿缝合可改善术后舒适度，代价是手术时间轻度增加。

英文摘要

OBJECTIVES: To compare the efficacy and safety of trans-septal suturing versus intranasal splinting after septoplasty through a systematic review and meta-analysis, focusing on post-operative complications and patient-centred outcomes.
METHODS: Comparative studies directly evaluating both techniques were included. Pooled odds ratios and standardised mean differences with 95 per cent confidence intervals were calculated.
RESULTS: Seventeen studies involving 1502 patients were included. No significant differences were found in adhesion, crust formation, septal haematoma, septal perforation or post-operative bleeding. Trans-septal suturing significantly reduced post-operative pain (standardised mean differences, -1.09; 95 per cent confidence intervals, -1.68 to -0.49) and sleep disturbance (standardised mean differences, -0.32; 95 per cent confidence intervals, -0.60 to -0.05) but increased operative time (standardised mean differences, 0.65; 95 per cent confidence intervals, 0.19-1.10). Infection and epiphora tended to be less frequent with trans-septal suturing.
CONCLUSION: Both techniques provide comparable protection against major post-operative complications, but trans-septal suturing improves post-operative comfort at the cost of a modest increase in operative time.