【摘要】：背景:目前,國內(nèi)外關于研究間置物關節(jié)成形術與關節(jié)重建術治療顳下頜關節(jié)強直的文獻不多,結論各異,療效存在爭議。目的:系統(tǒng)評價顳下頜關節(jié)強直患者行間置物關節(jié)成形與關節(jié)重建的療效。方法:計算機檢索維普中文科技期刊數(shù)據(jù)庫、萬方數(shù)據(jù)庫、PubMed、Ovid、Embase、Clinical Evidence、Cochrance圖書館等,并且結合手工檢索。收集2015年12月以前國內(nèi)外公開發(fā)表的間置物關節(jié)成形術與關節(jié)重建術治療顳下頜關節(jié)強直療效的臨床對照研究。按照納入標準和排除標準進行篩選文獻并對其進行質量評價。運用Stata13.1軟件對最大張口度和復發(fā)率進行Meta分析。結果與結論:(1)納入文獻:15篇;(2)最大張口度指標:總合并結果為MD=0.99,95%CI:(-1.43,3.40),Z=0.80,P=0.424,I2=73.9%;對其亞組分析結果顯示,顳肌筋膜瓣組與肋骨肋軟骨移植組:MD=0.84,95%CI:(-1.94,3.63),Z=0.59,P=0.553,I2=82.2%;其他材料組:MD=2.08,95%CI:(-3.03,7.19),Z=0.80,P=0.426,I2=0.0%;(3)復發(fā)率指標結果:為OR=1.13,95%CI:(0.59,2.15),Z=0.36,P=0.721,I2=0.0%;(4)Egger檢驗和Begg檢驗結果:均顯示不存在發(fā)表偏倚;(5)敏感度檢驗結果顯示:所納入的研究對Meta分析合并效應量無明顯影響,Meta分析結果穩(wěn)健;(6)分析結果提示:應用間置物關節(jié)成形與關節(jié)重建治療顳下頜關節(jié)強直患者,修復后最大張口度和復發(fā)率方面效果等同。受納入研究數(shù)量和質量所限,所得結論尚需開展更多高質量研究予以驗證。
[Abstract]:Background: there are few literatures on the treatment of temporomandibular joint ankylosis by interposition arthroplasty and arthroplasty at home and abroad. Objective: to evaluate the effect of interposition arthroplasty and joint reconstruction in patients with temporomandibular joint ankylosis (TMJ). Methods: the database of Chinese science and technology periodicals, Wanfang database and PubMed,Ovid,Embase,Clinical Evidence,Cochrance library were searched by computer and combined with manual retrieval. To collect the clinical controlled study on the curative effect of arthroplasty and reconstruction of temporomandibular joint on ankylosis of temporomandibular joint published before December 2015. The literature was screened and evaluated according to inclusion criteria and exclusion criteria. The maximum opening degree and recurrence rate were analyzed by Meta with Stata13.1 software. Results and conclusion: (1) included in the literature: 15 articles; (2) maximum opening index: total combined result was MD=0.99,95%CI: (-1.43 鹵3.40). 棰炶倢絳嬭啘鐡ｇ粍涓庤倠楠ㄨ倠杞縐繪緇，

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