单侧髁突骨折治疗的meta分析

摘要/Abstract

摘要： 目的: 采用meta 分析方法对比单侧下颌骨髁突骨折的手术治疗与保守治疗的疗效。方法: 全面检索Cochrane Library、PubMed、Embase、CNKI、CBM、维普及万方数据库中有关单侧髁突骨折的疗效对比的随机对照试验(randomized controlled trials, RCTs),检索时段为建库至2015-09-25,按照筛选标准选择文献、提取资料,采用RevMan5.3软件进行meta分析。结果: 共纳入5项RCTs,197例患者。Meta分析结果显示,手术治疗组的最大开口度(WMD:5.60,95% CI:4.42~6.77,P<0.01)、前伸距离(WMD:1.30,95% CI:0.35~2.25,P<0.01)及双侧侧方距离之和(WMD:2.50,95% CI:1.77~3.22,P<0.01)优于保守治疗组,并且手术治疗组的颞下颌关节疼痛发生率低于保守治疗组(OR:0.14,95% CI:0.04-0.43,P<0.01),但2组的错发生率无显著差异(OR:0.33,95% CI:0.07~1.46,P>0.05)。结论: 相比保守治疗,手术治疗后的开口度、前伸及侧方运动恢复更好,并且颞下颌关节疼痛发生率更低。

关键词: 髁突骨折, 手术治疗, 保守治疗, Meta分析

Abstract: PURPOSE: To evaluate the effect of open and closed treatment of unilateral mandibular condyle fractures using meta-analysis. METHODS: Databases as the Cochrane Library, PubMed, Embase, CNKI, CBM, VIP, and Wanfang Data were searched from inception to September 25, 2015. All randomized clinical trials (RCTs) on treatment of unilateral mandibular condyle fractures were collected, and then selected on the basis of the inclusion and exclusion criteria. The data were extracted from the included articles and meta analysis was performed using RevMan5.3. RESULTS: A total of 5 RCTs involving 197 patients were included and analyzed. The results of meta analysis showed that the maximal mouth opening (WMD: 5.60, 95% CI:4.42-6.77, P<0.01), protrusion (WMD:1.30, 95% CI:0.35-2.25, P<0.01) and sum of bilateral laterotrusions (WMD: 2.50, 95% CI:1.77-3.22, P<0.01) of open surgery were significantly higher than conservative treatment. The incidence of temporomandibular joint pain was significantly lower than conservative treatment (OR:0.14, 95% CI:0.04-0.43, P<0.01). There was no significant difference in incidence of malocclusion between the 2 groups (OR:0.33, 95% CI:0.07-1.46,P>0.05). CONCLUSIONS: Compared with conservative treatment, open surgery has significant advantages in improving mouth opening and mandibular movement, and reducing the incidence of joint pain.

Key words: Condyle fracture, Open Surgery, Conservative treatment, Meta analysis

中图分类号:

R782.4

韩小东, 林小臻, 邵小钧, 王燕一, 张明. 单侧髁突骨折治疗的meta分析[J]. 中国口腔颌面外科杂志, 2016, 14(5): 455-460.

HAN Xiao-dong, LIN Xiao-zhen, SHAO Xiao-jun, WANG Yan-yi, ZHANG Ming. Open versus closed treatment of unilateral mandibular condyle fractures: a meta analysis of randomized controlled trials[J]. China J Oral Maxillofac Surg, 2016, 14(5): 455-460.

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