【摘要】：背景:目前,國(guó)內(nèi)外關(guān)于研究間置物關(guān)節(jié)成形術(shù)與關(guān)節(jié)重建術(shù)治療顳下頜關(guān)節(jié)強(qiáng)直的文獻(xiàn)不多,結(jié)論各異,療效存在爭(zhēng)議。目的:系統(tǒng)評(píng)價(jià)顳下頜關(guān)節(jié)強(qiáng)直患者行間置物關(guān)節(jié)成形與關(guān)節(jié)重建的療效。方法:計(jì)算機(jī)檢索維普中文科技期刊數(shù)據(jù)庫(kù)、萬(wàn)方數(shù)據(jù)庫(kù)、PubMed、Ovid、Embase、Clinical Evidence、Cochrance圖書(shū)館等,并且結(jié)合手工檢索。收集2015年12月以前國(guó)內(nèi)外公開(kāi)發(fā)表的間置物關(guān)節(jié)成形術(shù)與關(guān)節(jié)重建術(shù)治療顳下頜關(guān)節(jié)強(qiáng)直療效的臨床對(duì)照研究。按照納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)進(jìn)行篩選文獻(xiàn)并對(duì)其進(jìn)行質(zhì)量評(píng)價(jià)。運(yùn)用Stata13.1軟件對(duì)最大張口度和復(fù)發(fā)率進(jìn)行Meta分析。結(jié)果與結(jié)論:(1)納入文獻(xiàn):15篇;(2)最大張口度指標(biāo):總合并結(jié)果為MD=0.99,95%CI:(-1.43,3.40),Z=0.80,P=0.424,I2=73.9%;對(duì)其亞組分析結(jié)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(fù)發(fā)率指標(biāo)結(jié)果:為OR=1.13,95%CI:(0.59,2.15),Z=0.36,P=0.721,I2=0.0%;(4)Egger檢驗(yàn)和Begg檢驗(yàn)結(jié)果:均顯示不存在發(fā)表偏倚;(5)敏感度檢驗(yàn)結(jié)果顯示:所納入的研究對(duì)Meta分析合并效應(yīng)量無(wú)明顯影響,Meta分析結(jié)果穩(wěn)健;(6)分析結(jié)果提示:應(yīng)用間置物關(guān)節(jié)成形與關(guān)節(jié)重建治療顳下頜關(guān)節(jié)強(qiáng)直患者,修復(fù)后最大張口度和復(fù)發(fā)率方面效果等同。受納入研究數(shù)量和質(zhì)量所限,所得結(jié)論尚需開(kāi)展更多高質(zhì)量研究予以驗(yàn)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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