使用霰粒肿镊子进行改良唇唾液腺活检的手术优势:一项前瞻性随机对照研究。

IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Chunyan Li, WenDan Zheng, Yingying Tian, Yong Chen, ShiYu Chui, YuZuo Luo, Xuejiao Lou, Yuren Wang, Mei Tian
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引用次数: 0

摘要

唇唾液腺活检(LSGB)是原发性斯约格伦综合征(pSS)的特定诊断标准之一。传统的唇唾液腺活检没有下唇固定装置,术中出血导致视野不清,而且切口较大,不利于伤口愈合。使用辅助装置来改善传统 LSGB 技术的缺点将是非常有意义的。因此,本病例对照研究旨在评估使用霰粒肿钳的改良 LSGB 与传统 LSGB 相比的价值。在获得所有参与研究的家长和患者的书面知情同意后,我们将 217 名符合条件的参与者随机分配到使用霰粒肿钳进行 LSGB(125 人)或传统 LSGB(92 人)。结果变量包括手术时间、切口长度、术中出血量、术后 24 小时疼痛评分、术后 7 天切口愈合情况、腺体采集和病理结果。比较两种手术方法的最终诊断结果,并比较两组病理结果与最终临床诊断的吻合率。数据采用参数和非参数检验进行分析。与传统组相比,改良组切口更小、手术时间更短、失血量更少、24 小时疼痛评分更低、术后 7 天切口 A 级愈合更好(P 0.05)。通过多变量回归分析,只有病灶评分(FS)≥1(P 80.0%)才能诊断为 pSS。不同手术方法组的阳性活检结果与专家意见和2016 ACR-EULAR原发性SS分类标准一致。使用辅助霰粒肿钳的改良LSGB具有切口小、手术时间短、出血少、疼痛轻、术后并发症发生率低等优点,安全性好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Surgical advantage of modified labial salivary gland biopsy using chalazion forceps: a prospective randomized controlled study.

Surgical advantage of modified labial salivary gland biopsy using chalazion forceps: a prospective randomized controlled study.

Labial salivary gland biopsy (LSGB) is one of the specific diagnostic criteria for primary Sjögren's syndrome (pSS). In traditional LSGB, there is no lower lip fixation device, the field of view is unclear due to intraoperative bleeding, and the incision is large, which is unfavourable for healing. The use of auxiliary devices to improve the shortcomings of traditional LSGB technique would be meaningful. Therefore, this case-control study aimed to assess the value of modified LSGB using chalazion forceps as compared with traditional LSGB. After obtaining written informed consent from all participating parents and patients, we randomly assigned 217 eligible participants to undergo LSGB using chalazion forceps (n = 125) or traditional LSGB (n = 92). The outcome variables were surgical time, incision length, intraoperative bleeding, pain score at 24 h after surgery, incision healing status at 7 days after surgery, gland collection, and pathological results. The final diagnostic results of the two surgical methods were compared, and the match rates between the pathological results and the final clinical diagnoses were compared between the two groups. The data were analysed using parametric and nonparametric tests. Compared with the traditional group, the modified group had a smaller incision, shorter operative time, less blood loss, lower 24 h pain score, and better Grade A incision healing at 7 days after surgery (p < 0.01). There was no statistically significant difference between the patients in the two surgical-method groups in terms of the positive biopsy results and the final diagnosis based on expert opinions (p > 0.05). By multivariable regression analysis, only a focus score (FS) of ≥ 1 (p < 0.01), dry eye disease (p < 0.05) and anti-nuclear antibodies (ANA) titre ≥ 1:320 (p < 0.05) were correlated with the diagnosis of pSS. The positive biopsy results of patients in the different surgical-method groups had a biopsy accuracy of > 80.0% for the diagnosis of pSS. The positive biopsy results in the different surgical-method groups were consistent with the expert opinions and the 2016 ACR-EULAR primary SS classification criteria. The modified LSGB using an auxiliary chalazion forceps offers a good safety with a small incision, shorter operative time, less bleeding, reduced pain and a low incidence of postoperative complications.The match rate of LSGB pathological results of the proposed surgical procedure with the final diagnosis of pSS is high.

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来源期刊
Clinical and Experimental Medicine
Clinical and Experimental Medicine 医学-医学:研究与实验
CiteScore
4.80
自引率
2.20%
发文量
159
审稿时长
2.5 months
期刊介绍: Clinical and Experimental Medicine (CEM) is a multidisciplinary journal that aims to be a forum of scientific excellence and information exchange in relation to the basic and clinical features of the following fields: hematology, onco-hematology, oncology, virology, immunology, and rheumatology. The journal publishes reviews and editorials, experimental and preclinical studies, translational research, prospectively designed clinical trials, and epidemiological studies. Papers containing new clinical or experimental data that are likely to contribute to changes in clinical practice or the way in which a disease is thought about will be given priority due to their immediate importance. Case reports will be accepted on an exceptional basis only, and their submission is discouraged. The major criteria for publication are clarity, scientific soundness, and advances in knowledge. In compliance with the overwhelmingly prevailing request by the international scientific community, and with respect for eco-compatibility issues, CEM is now published exclusively online.
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