鼻内皮质类固醇治疗腺样体肥大的有效性和安全性：系统回顾和荟萃分析

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-06-27 DOI:10.1016/j.ijporl.2025.112450

Abdulsalam Alqutub , Sarah F. Mozahim , Naif F. Mozahim , Osama A. Alsulami , Sarah M. AlSharif , Abeer Z. Malebari , Talal Al-Khatib

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引用次数: 0

摘要

腺样肥大是一种常见的疾病，可导致显著的症状和可能的并发症。鼻内皮质类固醇已成为一种很有前途的非手术治疗方法。本研究旨在评估鼻内皮质类固醇治疗鼻炎的有效性和安全性。方法从成立到2024年11月，我们对四个电子数据库进行了彻底的检索。我们的研究包括了所有可用的比较鼻内皮质类固醇与任何比较物治疗腺样体肥大的研究。研究结果包括腺样体切除术率、治疗后临床症状评分、腺样体肥大程度、腺样体大小和不良反应。分类变量合并为风险比（RR）。使用标准化平均差异（SMD）对连续结果进行汇总，置信区间为95%。结果30项涉及2301例腺样体肥大儿童的研究纳入我们的分析。我们的汇总结果显示，与对照组相比，鼻内皮质类固醇治疗的患者腺样体切除术率较低(RR = 0.30, 95% CI[0.17至0.54],P <；0.0001)。鼻内皮质类固醇组也表现出较低的总体临床症状评分(SMD = - 0.81, 95% CI [-1.01 ~ - 0.60], P <；0.00001)和较小的腺样体大小(SMD = - 1.33, 95% CI,[-1.91至- 0.75],P <；0.00001)。结论鼻内皮质类固醇可缩小腺样体大小，改善临床症状，减少腺样体切除术的需要，是治疗腺样体肥大的有效药物。临床医生应将鼻内皮质类固醇纳入治疗方案，以减轻临床症状，并可能避免手术。为了支持我们的结果，建议进一步进行大规模随机对照试验，延长随访期。

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Effectiveness and safety of intranasal corticosteroids for adenoid Hypertrophy: A systematic review and meta-analysis

Background

Adenoid hypertrophy is a common condition that can lead to significant symptoms and possibly complications. Intranasal corticosteroids have emerged as a promising non-surgical treatment for this condition. Our study aims to evaluate the effectiveness and safety of intranasal corticosteroids in managing it.

Methods

From inception to November 2024, we conducted a thorough search across four electronic databases. Our study included all available research comparing intranasal corticosteroids to any comparator in managing adenoid hypertrophy. The study's outcomes were the rate of adenoidectomy, post-treatment clinical symptoms scores, adenoid hypertrophy grade, adenoid size, and adverse effects. The categorical variables were pooled as risk ratios (RR). Continuous outcomes were pooled using the standardized mean differences (SMD) with a 95 % confidence interval (CI).

Results

Thirty studies involving 2301 children with adenoid hypertrophy were included in our analysis. Our pooled results showed a lower rate of adenoidectomy in patients treated with intranasal corticosteroids compared to the control group (RR = 0.30, 95 % CI [0.17 to 0.54], P < 0.0001). The intranasal corticosteroids group also exhibited a significantly lower overall clinical symptoms score (SMD = −0.81, 95 % CI [-1.01 to −0.60], P < 0.00001) and smaller adenoid size (SMD = −1.33, 95 % CI, [-1.91 to −0.75], P < 0.00001).

Conclusion

Intranasal corticosteroids are effective for treating adenoid hypertrophy, as they reduce adenoid size, improve clinical symptoms, and decrease the need for adenoidectomy. Clinicians should incorporate intranasal corticosteroids into treatment regimens to alleviate clinical symptoms and potentially avoid surgery. To support our results, further large-scale randomized controlled trials with extended follow-up periods are recommended.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.