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目的:系统评价诱导睡眠状态下电子鼻咽喉镜检查对于OSAHS成人患者上气道多平面阻塞诊断的临床价值。方法:按照Cochrane系统评价的方法,检索MEDLINE(PubMed)、EMBASE、CCTR(The Cochrane Controlled Clinical Trials Register Database)、中国知网、万方数据库等。检索国内外发表的截止2016年1月关于睡眠内镜在OSAHS定位诊断中的临床应用价值的研究。使用分析软件Meta-Disc1.4对提取的数据进行统计学分析。结果:最终纳入定性研究的文献7篇,纳入定量分析的文献3篇,纳入定量分析的研究试验3个,共175例患者,合并敏感度、特异度及95%CI分别为1.0(0.96~1.0)、0.71(0.59~0.81),合并诊断比值比为212.47(36.07~1 251.56),合并阳性似然比(+LR)、合并阴性似然比(-LR)分别为4.40(1.28~15.16)、0.02(0~0.11),纳入研究的SROC曲线下面积为0.991 0。结论:纳入研究统计学分析的结果提示睡眠内镜对OSAHS患者上气道多平面阻塞的诊断敏感性高,可以作为OSAHS诊断的重要辅助检查。但是纳入的文献数量有限,还需要更多大样本的质量高的队列研究试验来进一步检验。
OBJECTIVE: To evaluate the clinical value of electronic rhinopharyngoscopy in the induction of sleep-induced sleep apnea syndrome (OSAHS) for the diagnosis of multiple upper airway obstruction in adult patients. Methods: The MEDLINE (PubMed), EMBASE, CCTR (The Cochrane Controlled Clinical Trials Register Database), CNKI, Wanfang database and so on were searched according to the Cochrane systematic review. Retrieved at home and abroad as of January 2016 on the clinical application of sleep endoscopy in the diagnosis of OSAHS. Meta-Disc 1.4 was used to analyze the extracted data. Results: Seven papers were finally included in the qualitative study, three were included in the quantitative analysis, and three were included in the quantitative analysis study. A total of 175 patients with combined sensitivity, specificity and 95% CI were 1.0 (0.96-1.0 ) And 0.71 (0.59-0.81) respectively. The diagnostic odds ratio (OR) was 212.47 (36.07-1 251.56), positive likelihood ratio (+ LR) and negative LRR were 4.40 (1.28-15.16) 0.02 (0-0.11), and the area under the SROC curve included in the study was 0.991 0. CONCLUSION: The results of inclusion in research statics suggest that sleep endoscopy is highly sensitive to the diagnosis of OSAHS with upper airway multiplanar obstruction and may be used as an important auxiliary examination for OSAHS diagnosis. However, there is a limited number of articles to be included, and more large samples of high-quality cohort studies are needed to further examine them.