负压引流预防腮腺术后并发症的系统评价

目的:用系统评价方法评价负压引流在预防腮腺术后并发症方面的疗效及安全性。方法:计算机检索PubMed、Cochrane图书馆临床随机对照试验库、荷兰医学文摘、欧洲灰色文献数据库、中国生物医学文献数据库、维普数据库、万方数据库,检索时限为建库截至2013年3月10日;同时手工检索19种中文口腔医学杂志,搜集负压引流与开放式引流预防腮腺术后并发症的临床随机对照试验。2位评价者独立使用Cochrane 协作网推荐的标准对纳入文献进行偏倚风险评价并提取数据,采用Revman5.2软件进行meta分析。结果:最终纳入10项研究,偏倚风险评价显示均为中等偏倚风险。Meta分析结果显示,与开放式引流相比,负压引流能明显减少腮腺术后并发症(涎瘘/积液、血肿)的发生,提高临床综合疗效及患者的生活质量(P<0.05)。结论: 负压引流在预防腮腺术后并发症发生方面有一定的疗效和安全性,但还需要更多高质量的临床随机对照试验支持。

Closed suction drainage to prevent postoperative complications after parotidectomy: a systematic review

PURPOSE: To evaluate the efficacy and safety of closed suction drainage for prevention of postoperative complications after parotidectomy. METHODS: Pubmed, Cochrane Controlled Trials Register, Embase, Open Sigle, CBM, VIP and Wanfang database were searched electronically from the date of their establishment to May 10,2013. Hand-searching covering 19 relevant Chinese journals were also performed, and the literature of randomized controlled trials comparing closed suction drainage and open drainage for prevention of postoperative complications after parotidectomy were included. Risk of bias assessment, which was suggested by Cochrane handbook for systematic reviewers of intervention review, and data extraction of included studies were delivered by two reviewers in duplicate; and meta analysis was performed with Revman5.2 software. RESULTS: Ten randomized controlled trials were included. All studies had unclear risk of bias. When compared with open drainage, closed suction drainage showed a significant advantage on reducing postoperative complications (salivary fistula/effusion, edema ) after parotidectomy; it also improved clinical comprehensive effect and patients’ quality of life (P<0.05). CONCLUSIONS: To a certain extent, closed suction drainage has better efficacy and safety than controls in preventing postoperative complications after parotidectomy. However, as the quality of some included studies is limited, more randomized controlled trials are needed to reinforce the conclusion.