發(fā)布時(shí)間：2018-02-25 22:20

  本文關(guān)鍵詞： 下頜骨骨折 下頜角骨折 下頜骨正中及正中旁骨折 Meta分析　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:下頜骨骨折的手術(shù)治療一直被認(rèn)為頜面外科領(lǐng)域中一個(gè)爭(zhēng)議的話題,本研究應(yīng)用Meta分析方法系統(tǒng)評(píng)價(jià)不同的固定方法對(duì)下頜骨骨折治療的療效并確定哪個(gè)治療方案是下頜骨骨折的最佳選擇。方法:計(jì)算機(jī)檢索PubMed、Medline-Ovid,Embase等外文數(shù)據(jù)庫(kù),檢索時(shí)限為建庫(kù)至2017年1月,搜集國(guó)內(nèi)外有關(guān)不同內(nèi)固定方法對(duì)下頜骨骨折治療的隨機(jī)對(duì)照試驗(yàn)、隊(duì)列研究或病例對(duì)照研究,回顧性研究。3名評(píng)價(jià)員獨(dú)立處理文獻(xiàn)及數(shù)據(jù),對(duì)納入研究進(jìn)行質(zhì)量評(píng)估,采用Revman 5.2.6軟件對(duì)所得數(shù)據(jù)進(jìn)行Meta分析。結(jié)果:按照設(shè)計(jì)檢索方法檢索到1564篇相關(guān)文獻(xiàn),32篇納入文獻(xiàn),分別20篇為隨機(jī)對(duì)照試驗(yàn),4篇為病例對(duì)照研究,8篇為回顧性研究;其18篇為低偏倚,7篇為中偏倚,7篇為高偏倚的文章。Meta分析結(jié)果示:三維微型接骨板,拉力螺釘比較傳統(tǒng)的內(nèi)固定有統(tǒng)計(jì)學(xué)上顯著的意義,但鎖釘板與傳統(tǒng)板之間沒(méi)有統(tǒng)計(jì)學(xué)意義(P=0.2),累積優(yōu)勢(shì)比為0.64,這意味著使用鎖定板對(duì)下頜骨骨折的固定中減少術(shù)后并發(fā)癥的風(fēng)險(xiǎn)36%。結(jié)論:三維,二維微型接骨板的對(duì)比顯示三維板降低術(shù)后并發(fā)癥而且有顯著地統(tǒng)計(jì)學(xué)意義,三維微型接骨板是下頜骨骨折治療中的最佳治療方案,另外,使用螺釘板優(yōu)于二維微型接骨板即減少術(shù)后并發(fā)癥的發(fā)生率,兩種固定技術(shù)中螺釘板是下頜骨骨折治療中最好的方法;鎖定鋼板與非鎖定鋼板的結(jié)果顯示沒(méi)有統(tǒng)計(jì)學(xué)意義,但使用鎖定鋼板可減少術(shù)后并發(fā)癥,我們尚需要開(kāi)展大樣本多、中心、方法科學(xué)、設(shè)計(jì)嚴(yán)謹(jǐn)、規(guī)范的高質(zhì)量隨機(jī)對(duì)照試驗(yàn)進(jìn)行進(jìn)一步論證,以獲得更為可靠地證據(jù)。鎖定板是治療下頜骨骨折的潛在前途的固定系統(tǒng)。
[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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R782.4

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本文編號(hào)：1535376