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目的:应用meta分析的方法对CO2激光治疗早期声门型喉癌不同分期(Tis、T1N0M0、T2N0M0)的疗效进行评价。方法:检索万方期刊库、中国期刊网(清华同方)、中国科技期刊库(重庆维普)、PubMed、EM-BASE、OVID、PML(Proquest Medical Library)数据库中的杂志、学位论文等。制定严格的纳入和排除标准,对相关文献进行筛查、质量评价和资料提取。对符合入选标准的资料运用RevMan 5.0软件进行meta分析。在进行异质性检验后选择适当的统计模型,进行资料合并,以Tis、T1N0M0、T2N0M0期声门型喉癌CO2激光术后复发率为观察指标,对比CO2激光治疗早期声门型喉癌的疗效。结果:经筛选,有27篇国内外文献符合循证分析的要求,对其进行meta分析。Tis组和T1组相比差异无统计学意义(P<0.05);T1a组和T1b组相比差异有统计学意义(P<0.01);T1组和T2组相比差异无统计学意义(P<0.05);前联合受累组和前联合阴性组相比差异有统计学意义(P<0.05)。结论:应用CO2激光治疗早期声门型喉癌时,不同的分期对术后复发率有不同程度的影响,Tis期与T1期及T1期与T2期术后复发率无明显差异,T1a期术后复发率低于T1b期,前联合受累组术后复发率高于对照组。
OBJECTIVE: To evaluate the efficacy of CO2 laser in treatment of early stage glottis of the glottic carcinoma at different stages (Tis, T1N0M0, T2N0M0) by meta-analysis. Methods: We searched magazines, dissertations, etc. in Wanfang Periodicals, China Journal Net (Tsinghua Tongfang), China Science and Technology Periodicals Library (Chongqing Wipu), PubMed, EM-BASE, OVID and PML (Proquest Medical Library) databases. Formulate strict inclusion and exclusion criteria, screening relevant literature, quality evaluation and data extraction. RevMan 5.0 software was used for meta-analysis of data that met the inclusion criteria. In the heterogeneity test after selecting the appropriate statistical model, the data were combined to Tis, T1N0M0, T2N0M0 glottic laryngeal CO2 laser postoperative recurrence rate as an index, compared with CO2 laser treatment of early glottic laryngeal cancer Efficacy. Results: After screening, 27 domestic and foreign literatures were in accordance with the requirements of evidence-based analysis and meta-analysis. There was no significant difference between Tis group and T1 group (P <0.05); there was significant difference between T1a group and T1b group (P <0.01); there was no significant difference between T1 group and T2 group (P <0.05). There was significant difference between the former combination group and the former combination negative group (P <0.05). CONCLUSIONS: CO2 laser treatment of early glottic laryngeal cancer, different stages of postoperative recurrence rate to varying degrees, Tis period and T1 and T1 and T2 postoperative recurrence rate was no significant difference, T1a surgery The recurrence rate was lower than that of T1b. The recurrence rate of the former combination group was higher than that of the control group.