脱细胞真皮基质预防Frey综合征的系统评价

目的系统评价脱细胞真皮基质(AMD)预防Frey综合征的有效性和安全性。方法计算机检索Cochrane图书馆(2010年第1期)、MEDLINE、EMbase、SIGLE、GreyNet、NTIS、CBMdisc、VIP、CNKI和万方数据库,查找有关应用脱细胞真皮基质预防Frey综合征的研究。检索时限均为1995～2010年。由4名评价者独立选择试验、提取资料和评估方法学质量,然后采用RevMan 5.0.0软件对资料进行Meta分析。结果共纳入15个研究,共计472例受试患者。Meta分析结果显示,植入ADM能有效降低Frey综合征发生,其主观和客观差异均有统计学意义[RR=0.11,95%CI(0.06,0.18),P<0.01;RR=0.14,95%CI(0.10,0.19),P<0.01];暂时性面神经麻痹的发生率低于对照组,其差异无统计学意义[OR=0.78,95%C(I0.37,1.66),P=0.53];血清肿及粘液囊肿的发生率高于对照组,其差异也无统计学意义[OR=2.63,95%CI(0.09,79.25),P=0.58],并可以通过放置引流和局部加压包扎解决;涎漏的发生率低于对照组,其差异有统计学意义[OR=0.24,95%CI(0.08,0.69),P=0.009]。结论本系统评价结果显示,应用ADM能有效降低Frey综合征的发生率,安全性较好。建议术前行碘酒/碘伏过敏检查,术中行快速冰冻切片明确肿瘤性质,尽量固定牢固,术后放置负压引流及行局部加压包扎。

Efficacy and Safety of Acellular Dermal Matrix in Preventing Frey Syndrome:A Systematic Review

Objective To evaluate the efficacy and safety of acellular dermal matrix(ADM) in preventing Frey syndrome.Methods Studies of acellular dermal matrix in preventing Frey syndrome were searched in The Cochrane Library(Issue 1,2010),MEDLINE,EMbase,SIGLE,GreyNet,NTIS,CBMdisc,VIP,CNKI and WANFANG DATA from 1995 to 2010.All the studies were selected,extracted and evaluated by four reviewers independently,and meta-analyses were performed with RevMan 5.0.0 software.Results A total of 15 studies involving 472 partici...