摘要
目的评估射频温控减容术(radiofrequency volumetric tissue reduction,RFVTR)治疗睡眠障碍性呼吸(sleep disordered breathing,SDB)的有效性.方法计算机检索Cochrane图书馆(2005年第1期)、MEDLINE(1950～2005.4)、EMBASE(1989～2005.4)、CINAHL(1982～2000.10)、VIP(1989～2004.12)、中国学术期刊全文数据库(1979～2005)、中国生物医学文献光盘数据库(1978～2005)、万方数据资源(1977～2004),手检纳入文献的参考文献,并查找相关会议文献,询问本领域的专家以获取相关资料.纳入所有比较RFVTR与其他方法治疗SDB的随机、半随机对照试验,前瞻性队列研究.由两名研究者分别收集资料,并对纳入研究进行质量评价,采用RevMan4.2.3软件进行Meta分析.结果共纳入11篇文献,540名观察对象.其中随机对照研究5篇,前瞻性队列研究6篇,大部分研究存在方法学不足.与安慰剂比较,RFVTR在多导睡眠监测仪(PSG)指标睡眠呼吸暂停指数(AI)方面优于安慰剂,在其它PSG指标睡眠呼吸暂停/低通气指数(AHI)和最低氧合蛋白饱和度(LAST),睡眠及生活质量问卷结果,疼痛及吞咽障碍方面,差异无统计学意义.RFVTR在PSG指标、睡眠及生活质量问卷结果方面,与持续正压通气(CPAP)、悬雍垂咽腭裂成形术(UPPP)和激光辅助悬雍垂咽腭裂成形术(LAUP)比较,无显著统计学差异;但在疼痛及吞咽障碍方面,明显低于UPPP和LAUP.结论现有证据表明,RFVTR在改善AI方面优于安慰剂;在减轻疼痛及其他副作用方面优于其他治疗方法.目前尚无证据表明RFVTR在提高睡眠及生活质量方面优于其他SDB治疗方法,还需要进行更多高质量的研究以明确RFVTR治疗SDB的有用性,进一步确定疾病的严重程度、治疗次数对治疗效果的影响.
Objective To evaluate the effectiveness ofradiofrequency volumetric tissue reduction （RFVTR） in the treatment of sleep disordered breathing （ SDB ）. Methods We searched The Cochrane Central Register of Controlled Trials （Issue 1, 2005）, MEDLINE （1966 to Apr. 2005）, EMBASE （1989 to Apr. 2005）, CINAHL （1982 to Dec. 2000）, VIP （1989 to Dec. 2004） , CJFD （1979 to 2005）, WANFANG DATA （1977 to 2004） , and CBMdisc （1978 to 2005）. The bibliographies of all papers retrieved in full text form and relevant narrative reviews were searched for additional publications. All randomized controlled clinical trials （RCT） or quasi-randomized controlled trials （quasi-RCT） or prospective cohort studies of RFVTR alone or in combination with other treatments compared with placebo or other treatments were included. Data were extracted independently from the trial reports by the two authors. Meta-analysis was performed using RevMan software. Results There were 11 studies including 540 patients met the inclusion criteria for this review, among which five were RCTs, six were prospective cohort studies, and all trials were of lower methodological quality. RFVTR showed benefit over placebo in apnea index （AI）, but this benefit was not seen in other polysorrmography （PSG） parameters, symptom and quality of life, psychomotor vigilance pain, swallowing difficulty and adverse events. Compared with continuous positive airway pressure （CPAP）, uvulopalatopharyngoplasty （UPPP） and laser assisted uvulopalatoplasty （LAUP） , RFVTR was more effective in psychomotor vigilance pain and swallowing difficulty, but this effect was not seen in PSG parameters, symptom and quality of life. Conclusions RFVTR is more effective than placebo in AI improvement and other treatments in decreasing postoperative pain and other adverse events ; but this benefit was not seen in improving quality of sleeping and life. More well-designed randomized trials need to be conducted to identify the effectiveness and the influence on effectiveness of severity and frequency of treatment.
出处
《中国循证医学杂志》
CSCD
2005年第11期846-853,共8页
Chinese Journal of Evidence-based Medicine
关键词
射频治疗
射频温控减容术
睡眠障碍性呼吸
系统评价
Radiofrequency treatment
Radiofrequency volumetric tissue reduction
Sleep disordered breathing
Systematic review
