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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Tratamento de granulomas laríngeos decorrentes de intubação endotraqueal revisão sistemática e metanálise proporcional /

Rimoli, Caroline Fernandes. January 2016 (has links)
Orientador: Regina Helena Garcia Martins / Coorientador: Daniele Cristina Cataneo / Resumo: Introdução: os granulomas laríngeos são lesões benignas, não neoplásicas, uni ou bilaterais, de etiologia variável, que ocorrem no terço posterior das pregas vocais ou na região aritenoídea. Os sintomas são diversos, sendo o mais comum a rouquidão. Os granulomas decorrentes de intubação são altamente recidivantes e não existe consenso quanto ao melhor tratamento. Objetivo: comparar a efetividade dos tratamentos dos granulomas laríngeos decorrentes de intubação endotraqueal. Métodos: foram realizadas revisão sistemática e metanálise proporcional de estudos sobre o tratamento de granulomas laríngeos decorrentes de intubação endotraqueal, seja ele primário ou recidivante. Os critérios de elegibilidade foram: ensaios clínicos randomizados e estudos prospectivos controlados, e na ausência destes, aceitos também estudos retrospectivos e prospectivos não controlados com no mínimo cinco participantes. Os desfechos estudados foram resolução, recidiva e tempo para resolução do granuloma. Os estudos foram identificados na base de dados Pubmed, Embase, Lilacs e Cochrane. Para a análise dos dados e metanálise, utilizou-se o programa StatsDirect 3.0.121. Resultados: dentre os 578 artigos encontrados, 61 foram lidos na íntegra e seis selecionados para a revisão, totalizando 85 pacientes, com idade variando de 21 a 86 anos. Os tratamentos encontrados foram: antirrefluxo, fonoterapia, anti-inflamatórios, corticoterapia, antibioticoterapia, sulfato de zinco e cirurgia. Para o tratamento primár... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Laryngeal granulomas are benign, non-neoplastic lesions that can occur unilaterally or bilaterally for various causes. They are usually located in the posterior third of the vocal folds or in the arytenoid region. Patients may present a number of symptoms, the main one being hoarseness. Post-intubation granulomas are highly recurrent and there is no consensus on the best treatment. Objective: to compare the effectiveness of treatments of laryngeal granulomas secondary to endotracheal intubation. Methods: systematic review and proportion meta-analysis of studies that address the treatment of laryngeal granulomas caused by endotracheal intubation. The eligibility criteria were: randomized controlled trials and controlled prospective studies, and in the absence of these, retrospective and prospective uncontrolled studies were also accepted, with at least five participants. The outcomes that were measured were resolution, recurrence and time to resolve the granuloma. Databases searched were Pubmed, Embase, Lilacs and Cochrane. Statistical analysis was performed with the StatsDirect version 3.0.121 software. Results: among the 578 articles found, 61 were eligible for full reading and 11 articles were included, involving 85 patients, with ages varying from 21 to 86 years). The treatments were: anti-reflux, speech therapy, anti-inflammatory drugs, corticosteroids, antibiotics, zinc sulfate and surgery. For the primary treatment, 85 patients were investigated in six studies, divided into two groups: surgical ± associations (41 patients), with chance of resolution of 75% (95% CI: 0,3% to 100%, I2= 90%), and absolute risk of recurrence of 25% (95% CI: 0,2% to 71%) and clinical (44 patients), with chance of resolution of 86% (95% CI: 67% to 97%), and absolute risk of recurrence of 14% (95% CI: 3 to 33%). In the interpretation of the meta-analysis, there was no statistical significance... (Complete abstract click electronic access below) / Mestre

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