手术干预开角型青光眼临床研究证据 图谱

Evidence Map of Clinical Research on Surgical Interventions for Open-Angle Glaucoma

摘要: 目的：通过对手术干预开角型青光眼的临床研究文献进行整理和分析，探索并呈现手术干预开角型青光眼的证据质量。方法：检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、PubMed、Web of Science、Embase数据库中手术干预开角型青光眼的临床研究文献，对纳入的文献用Excel整理，进行手术干预开角型青光眼的临床证据图谱取表，对样本量、干预措施、疗效评价指标、文献质量评价等内容进行统计分析，并制作气泡图、流程图、偏倚风险图等，将该领域相关证据进行可视化处理并分析。结果：最终纳入47篇临床研究，干预措施中内路小梁切开术(GT)占比较大，Ex-PRESS引流钉植入术占比较小。文献质量评价方面，高风险偏倚占大部分。证据图谱显示，手术干预开角型青光眼有一定疗效，纳入文献中共有66项研究，其结局中20项为有效，27项为可能有效，16项为不确定，3项为无差别效应。结论：手术在干预开角型青光眼方面显示出一定疗效，其临床应用已被广泛报道，然而，纳入的临床研究的偏倚风险较高，限制了可靠性和证据的强度。未来需要高质量的研究来提高证据质量。

Abstract: Objective: To explore and present the quality of evidence for surgical intervention in open-angle glaucoma through the collation and analysis of clinical research literature on this topic. Methods: Clinical research literature on surgical intervention for open-angle glaucoma was retrieved from databases including CNKI, Wanfang, VIP, PubMed, Web of Science, and Embase. The included literature was organized using Excel, and a clinical evidence map was created for surgical intervention in open-angle glaucoma. Statistical analysis was conducted on sample size, intervention measures, outcome evaluation indicators, and literature quality assessment. Bubble charts, flowcharts, and bias risk diagrams were produced to visualize and analyze the relevant evidence in this field. Results: A total of 47 clinical studies were included. Among the intervention measures, trabeculotomy (GT) accounted for a large proportion, while Ex-PRESS shunt implantation accounted for a small proportion. In terms of literature quality assessment, high-risk bias was predominant. The evidence map indicated that surgical intervention for open-angle glaucoma had certain therapeutic effects. Among the 66 studies included in the literature, 20 were effective, 27 were possibly effective, 16 were uncertain, and 3 showed no difference in effect. Conclusion: Surgery has shown certain therapeutic effects in the intervention of open-angle glaucoma and has been widely reported in clinical applications. However, the included clinical studies had a high risk of bias, which limited the reliability and strength of the evidence. Future high-quality research is needed to improve the quality of evidence.