下颌骨骨折手术治疗的Meta分析

发布时间：2018-02-25 22:20

本文关键词： 下颌骨骨折下颌角骨折下颌骨正中及正中旁骨折 Meta分析　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:下颌骨骨折的手术治疗一直被认为颌面外科领域中一个争议的话题,本研究应用Meta分析方法系统评价不同的固定方法对下颌骨骨折治疗的疗效并确定哪个治疗方案是下颌骨骨折的最佳选择。方法:计算机检索PubMed、Medline-Ovid,Embase等外文数据库,检索时限为建库至2017年1月,搜集国内外有关不同内固定方法对下颌骨骨折治疗的随机对照试验、队列研究或病例对照研究,回顾性研究。3名评价员独立处理文献及数据,对纳入研究进行质量评估,采用Revman 5.2.6软件对所得数据进行Meta分析。结果:按照设计检索方法检索到1564篇相关文献,32篇纳入文献,分别20篇为随机对照试验,4篇为病例对照研究,8篇为回顾性研究;其18篇为低偏倚,7篇为中偏倚,7篇为高偏倚的文章。Meta分析结果示:三维微型接骨板,拉力螺钉比较传统的内固定有统计学上显著的意义,但锁钉板与传统板之间没有统计学意义(P=0.2),累积优势比为0.64,这意味着使用锁定板对下颌骨骨折的固定中减少术后并发症的风险36%。结论:三维,二维微型接骨板的对比显示三维板降低术后并发症而且有显著地统计学意义,三维微型接骨板是下颌骨骨折治疗中的最佳治疗方案,另外,使用螺钉板优于二维微型接骨板即减少术后并发症的发生率,两种固定技术中螺钉板是下颌骨骨折治疗中最好的方法;锁定钢板与非锁定钢板的结果显示没有统计学意义,但使用锁定钢板可减少术后并发症,我们尚需要开展大样本多、中心、方法科学、设计严谨、规范的高质量随机对照试验进行进一步论证,以获得更为可靠地证据。锁定板是治疗下颌骨骨折的潜在前途的固定系统。
[Abstract]:Objective: surgical treatment of mandibular fractures has been considered a controversial topic in the field of maxillofacial surgery. In this study, Meta analysis was used to systematically evaluate the efficacy of different fixation methods in the treatment of mandibular fractures and to determine which treatment regimen was the best choice for mandibular fractures. Methods: a computer-based database of PubMedMedline-OvidEmbase was searched. The time of retrieval was from January 2017 to January 2017. Random controlled trials, cohort studies or case-control studies on the treatment of mandibular fractures with different internal fixation methods at home and abroad were collected, and the literature and data were independently processed by 3 evaluators in a retrospective study. The data were analyzed by Meta using Revman 5.2.6 software. Results: according to the design retrieval method, 1 564 related literatures were retrieved, 32 of them were included. There were 20 randomized controlled trials and 4 case-control studies, 8 were retrospective studies, 18 were low bias, 7 were middle bias and 7 were high bias. The results of Meta analysis showed that: 3 D microplate, 3 D microplate, 3 D microplate, 3 D microplate, 3 D microplate, 3 D microplate, 3 D microplate, 3 D microplate, 3 D microplate, 3 D microplate, 3 D microplate, The pull screw has statistical significance compared with the traditional internal fixation. However, there is no statistical significance between the locking plate and the traditional plate, and the cumulative advantage ratio is 0.64, which means that the use of locking plate in the fixation of mandibular fracture reduces the risk of postoperative complications. The comparison of two-dimensional microplate showed that three-dimensional plate reduced postoperative complications and had significant statistical significance. Three-dimensional microplate was the best treatment for mandibular fracture, in addition, three dimensional microplate was the best method in the treatment of mandibular fracture. The use of screw plate is superior to that of two-dimensional miniature plate, which reduces the incidence of postoperative complications. The screw plate is the best method in the treatment of mandibular fracture, and the results of locking plate and non-locking plate show no statistical significance. However, the use of locking plate can reduce postoperative complications. We still need to conduct a large sample, center, scientific method, rigorous design, and standardized randomized controlled trials to further demonstrate. Locking plate is a potential fixation system for the treatment of mandibular fractures.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.4

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