摘要
目的系统评价微波消融(MWA)治疗继发性甲状旁腺功能亢进症(SHPT)的有效性和安全性。方法检索PubMed、Cochrane Library、Embase、中国知网和万方医学网自建库至2020年12月31日发表的MWA治疗SHPT相关文献。采用Stata 15.0软件分析MWA治疗SHPT的有效性和安全性。结果依据纳入及排除标准,最终纳入9篇文献、共249例SHPT患者。与消融前相比,MWA后1天[加权均数差(WMD)=1142.04,95%CI(783.03,1501.06),P<0.001]、1周[WMD=859.85,95%CI(758.97,960.74),P<0.001]、1个月[WMD=800.29,95%CI(687.12,913.47),P<0.001]和6个月[WMD=857.09,95%CI(746.07,968.11),P<0.001]的甲状旁腺激素(PTH)水平均显著降低;MWA后1天[WMD=0.39,95%CI(0.33,0.45),P<0.001;WMD=0.29,95%CI(0.16,0.41),P<0.001]和1周[WMD=0.23,95%CI(0.02,0.43),P<0.05;WMD=0.31,95%CI(0.02,0.61),P<0.05]钙和磷水平均下降。MWA后神经损伤发生率为1.20%[效应量(ES)=0.02,95%CI(-0.00,0.05),P>0.05],低钙血症发生率为21.69%[ES=0.60,95%CI(0.39,0.81),P<0.001],声音嘶哑发生率为5.62%[ES=0.06,95%CI(0.03,0.09),P<0.001],血肿发生率为1.61%[ES=0.03,95%CI(-0.01,0.06),P=0.095]。结论MWA治疗SHPT有效且安全。
Objective To systematically evaluate the efficacy and safety of microwave ablation(MWA)for treatment of secondary hyperparathyroidism(SHPT).Methods PubMed,Embase,Cochrane Library,CNKI and Wanfang Med Online were searched for relevant literatures published before December 31,2020.Then Stata 15.0 software was used for meta-analysis in evaluating the efficacy and safety of MWA for treatment of SHPT.Results According to the inclusion and exclusion criteria,a total of 249 patients from 9 articles were enrolled in this study.Compared with pre-ablation,the levels of parathyroid hormone(PTH)were significantly lower 1 day(weighted mean difference[WMD]=1142.04,95%CI[783.03,1501.06],P<0.001),1 week(WMD=859.85,95%CI[758.97,960.74],P<0.001),1 month(WMD=800.29,95%CI[687.12,913.47],P<0.001)and 6 months(WMD=857.09,95%CI[746.07,968.11],P<0.001)after MWA,while the levels of calcium and phosphorus were significantly lower 1 day(WMD=0.39,95%CI[0.33,0.45],P<0.001;WMD=0.29,95%CI[0.16,0.41],P<0.001)and 1 week(WMD=0.23,95%CI[0.02,0.43],P<0.05;WMD=0.31,95%CI[0.02,0.61],P<0.05)after MWA.The incidence of nerve injury was 1.20%(effect size[ES]=0.02,95%CI[-0.00,0.05],P>0.05)after MWA,of hypocalcemia was 21.69%(ES=0.60,95%CI[0.39,0.81],P<0.001),of voice hoarse was 5.62%(ES=0.06,95%CI[0.03,0.09],P<0.001),and of hematoma was 1.61%(ES=0.03,95%CI[-0.01,0.06],P=0.095).Conclusion MWA was effective and safe for treating SHPT.
作者
曹晓静
李妍
魏莹
赵朕龙
伍洁
彭丽丽
于明安
CAO Xiaojing;LI Yan;WEI Ying;ZHAO Zhenlong;WU Jie;PENG Lili;YU Ming'an(Department of Interventional Medicine, China-Japan Friendship Hospital,Beijing 100029, China)
出处
《中国介入影像与治疗学》
北大核心
2021年第10期577-582,共6页
Chinese Journal of Interventional Imaging and Therapy
基金
首都临床特色应用研究项目(Z181100001718135)
中日友好医院院级科研基金(2019-2-HL-4)。
