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首页> 外文期刊>Journal of Dentistry >Rapid Palatal Expansion to Treat Nocturnal Enuretic Children: a Systematic Review and Meta-Analysis
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Rapid Palatal Expansion to Treat Nocturnal Enuretic Children: a Systematic Review and Meta-Analysis

机译：快速扩宫治疗夜间遗尿症儿童：系统评价和荟萃分析

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Statement of the Problem: Refractory nocturnal enuresis possesses a heavy psychosocial burden for the affected child. Only a 15% spontaneous annual cure rate is reported. Purpose: This patient-level meta-analysis aimed to evaluate the efficacy of rapid palatal expansion to treat nocturnal enuresis among children. Materials and Method: A sensitive search of electronic databases of PubMed (since 1966), SCOPUS (containing EMBASE, since 1980), Cochrane Central Register of Controlled Trials, CINAHL and EBSCO till Jan 2014 was performed. A set of regular terms was used for searching in data banks except for PubMed, for which medical subject headings (MeSH) keywords were used. Children aged at least six years old at the time of recruitment of either gender who underwent rapid palatal expansion and had attempted any type of pharmacotherapy prior to orthodontic intervention were included. Results: Six non-randomized clinical trials were found relevant, of which five studies had no control group. Eighty children were investigated with the mean age of 118 (28.12) months ranged from 74 to 185 months. The median time to become completely dry was 2.87 months [confidence interval (CI) 95% 2.07-2.93 months]. After one year, the average rate of becoming complete dry was 31%. The presence of posterior cross bite [relative risk (RR): 0.31, CI 95%: 0.12-0.79] and signs of upper respiratory obstruction during sleep (RR: 5.1, CI 95%: 1.44-18.04) significantly decreased and increased the chance of improvement, respectively. Meanwhile, the other predictors did not significantly predict the outcome after simultaneous adjustment in Cox regression model. Conclusion: Rapid palatal expansion may be considered when other treatment modalities have failed. The 31% rate of cure is promising when compared to the spontaneous cure rate. Though, high-level evidence from the rigorous randomized controlled trials is scarce (Level of evidence: C).
机译：问题陈述：难治性夜间遗尿症对患病儿童的社会心理负担沉重。据报道，每年的自发治愈率只有15％。目的：这项患者水平的荟萃分析旨在评估快速pa扩展治疗儿童夜间遗尿症的疗效。资料和方法：对PubMed（自1966年以来），SCOPUS（自1980年以来包含EMBASE），Cochrane对照试验中央注册，CINAHL和EBSCO的电子数据库进行了敏感搜索，直到2014年1月。除PubMed外，使用了一组常规术语来搜索数据库，其中使用了医学主题词（MeSH）关键字。包括在招募任何性别时至少六岁的儿童，这些儿童经历了pa快速扩张并在正畸干预之前尝试了任何类型的药物治疗。结果：发现有6项相关的非随机临床试验，其中5项研究没有对照组。调查了80名儿童，平均年龄为118（28.12）个月，范围从74到185个月。完全干燥的中位时间为2.87个月[置信区间（CI）95％2.07-2.93个月]。一年后，完全干燥的平均率为31％。后交叉咬伤的存在[相对危险度（RR）：0.31，CI 95％：0.12-0.79]和睡眠期间上呼吸道阻塞的症状（RR：5.1，CI 95％：1.44-18.04）显着降低，增加了机会改善。同时，在同时调整Cox回归模型后，其他预测因素并未显着预测结果。结论：当其他治疗方式失败时，可考虑快速pa扩展。与自发治愈率相比，治愈率31％是有希望的。但是，严格的随机对照试验缺乏高水平的证据（证据水平：C）。

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