裂隙关节成形与间置物关节成形修复颞下颌关节强直的系统分析

发布时间：2018-03-21 02:16

本文选题：颞下颌关节　切入点：关节成形术　出处：《中国组织工程研究》2017年20期 　论文类型：期刊论文

【摘要】：背景:目前,国内外关于裂隙关节成形术与间置物关节成形术修复颞下颌关节强直的文献不多,结论各异,疗效存在争议。目的:评价颞下颌关节强直患者行裂隙关节成形术与间置物关节成形术的疗效及预后。方法:通过计算机检索万方数据库、维普中文科技期刊数据库、Pub Med数据库、Ovid、Embase、Clinical Evidence、Cochrance图书馆等,结合手工检索搜集2015年10月以前国内外公开发表的比较两种术式治疗颞下颌关节强直术后最大张口度和(或)复发率的临床对照研究。根据异质性检验结果,最大张口度指标采用随机效应模式,并以间置材料不同,分颞肌筋膜瓣组和其他材料组进行亚组分析,计算MD及95%CI;复发率指标采用固定效应模式,计算OR及95%CI。结果与结论:(1)按照纳入标准和排除标准,最终纳入文献18篇,共999例患者,裂隙关节成形术和间置物关节成形术分别为656例和343例;(2)Meta分析最大张口度指标总合并结果为MD=-1.85,95%CI:(-3.15,-0.55),Z=2.80,P=0.005,I~2=55.4%;其中亚组分析示颞肌筋膜瓣组:MD=-0.94,95%CI:(-1.84,-0.04),Z=2.05,P=0.040,I~2=0.0%;其他材料组:MD=-3.36,95%CI:(-6.66,-0.66),Z=2.39,P=0.017,I2=67.0%;(3)Meta分析复发率指标结果为OR=1.38,95%CI:(0.87,2.17),Z=1.37,P=0.170,I~2=14.9%;(4)Egger检验示纳入的文献不存在发表偏倚;(5)敏感度检验示在复发率指标中,有一项研究对Meta分析总合并效应量结果有一定的影响,其余Meta分析结果稳健;(6)结果表明,相比裂隙关节成形术,间置物关节成形术明显增加颞下颌关节强直患者术后张口度,但是两种术式的复发率相当。受纳入研究数量和质量所限,上述结论尚需开展更多高质量研究予以验证。
[Abstract]:Background: at present, domestic and foreign about fracture arthroplasty and interpositional arthroplasty repair of temporomandibular joint ankylosis literature, different conclusions, curative effect is controversial. Objective: the curative effect and prognosis evaluation of temporomandibular joint ankylosis underwent fracture arthroplasty and interpositional arthroplasty. Methods: Wanfang database by computer, Chinese VIP journal database Pub, Ovid, Embase, Med database, Clinical Evidence, Cochrance library, combined with the previous manual retrieval from October 2015 published at home and abroad and comparison of two kinds of type of the largest open treatment of temporomandibular joint ankylosis after surgery and (or) clinical control study on recurrence rate. According to the results of heterogeneity test, the maximum mouth opening index the random effects model, and with the interposition of different materials, divided the temporalis myofascial flap group and other materials group analysis, calculation of MD and 9 5%CI; the recurrence rate index using fixed effect model, calculation of OR and 95%CI. results and conclusion: (1) according to the inclusion and exclusion criteria, a total of 18 articles, a total of 999 cases of patients, fracture arthroplasty and interpositional arthroplasty were 656 cases and 343 cases; (2) Meta analysis indicators with maximum mouth opening the results of MD=-1.85,95%CI: (-3.15, -0.55), Z=2.80, P=0.005, I~2=55.4%; the subgroup analysis showed the temporalis myofascial flap group: MD=-0.94,95%CI: (-1.84, -0.04), Z=2.05, P=0.040, I~2=0.0%; other materials group: MD=-3.36,95%CI: (-6.66, -0.66), Z=2.39, P=0.017, I2=67.0%; (3) Meta recurrence rate analysis the results of OR=1.38,95%CI: index (0.87,2.17), Z=1.37, P=0.170, I~2=14.9%; (4) Egger test showed that there was no evidence of publication bias in the literature; (5) sensitivity test showed that the recurrence rate index, a study of total merger effect have a certain influence on the amount of the results of Meta analysis The rest of the Meta ring, the analysis results of sound; (6) the results show that the fracture compared with arthroplasty, interpositional arthroplasty significantly increased the temporomandibular joint ankylosis patients after mouth opening, but two kinds of surgical recurrence rate. The included limited quantity and quality of research, the conclusion still needs more high quality studies to verify.

【作者单位】：乌鲁木齐市口腔医院齿槽外科;新疆医科大学第一附属医院颌面创伤正颌外科;
【基金】：新疆医学动物模型研究重点实验室开放课题项目(XJDX1103-2013-05)~~
【分类号】：R782.61

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