中国组织工程研究

中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (4): 650-656.doi: 10.3969/j.issn.2095-4344.2017.04.026

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    

间置物关节成形与关节重建修复颞下颌关节强直效果功能的Meta分析

依沙克江•买买提1，吴  俊1，买买提吐逊•吐尔地2   

  1. 1乌鲁木齐市口腔医院齿槽外科，新疆维吾尔自治区乌鲁木齐市  830002；2新疆医科大学第一附属医院颌面创伤正颌外科，新疆维吾尔自治区乌鲁木齐市  830054
  • 收稿日期:2017-01-10 出版日期:2017-02-08 发布日期:2017-03-13
  • 通讯作者: 通讯作者：买买提吐逊?吐尔地，博士，副主任医师，副教授，硕士生导师，新疆医科大学第一附属医院颌面创伤正颌外科，新疆维吾尔自治区乌鲁木齐市 830054
  • 作者简介:依沙克江?买买提，男，1986年生，新疆维吾尔自治区吐鲁番市人，维吾尔族，2014年新疆医科大学毕业，硕士，医师，主要从事数字化医学，颌面部重建与修复的研究。
  • 基金资助:

    新疆医学动物模型研究重点实验室开放课题项目(XJDX1103-2013-05)

Efficacy of interpositional arthroplasty versus reconstruction arthroplasty for temporomandibular joint ankylosis: a Meta-analysis

Yishakejiang Maimaiti1, Wu Jun1, Maimaitituxun Tuerdi2   

  1. 1Department of Alveolar Surgery, Urumqi Stomatology Hospital, Urumqi 830002, Xinjiang Uyghur Autonomous Region, China; 2 Department of Maxillofacial Trauma and Orthognathic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Urumqi Autonomous Region, China
  • Received:2017-01-10 Online:2017-02-08 Published:2017-03-13
  • Contact: Corresponding author: Maimaitituxun Tuerdi, M.D., Associate chief physician, Associate professor, Master’s superviser, Department of Maxillofacial Trauma and Orthognathic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Urumqi Autonomous Region, China
  • About author:Yishakejiang Maimaiti, Master, Physician, Department of Alveolar Surgery, Urumqi Stomatology Hospital, Urumqi 830002, Xinjiang Uyghur Autonomous Region, China
  • Supported by:

    Open Projects of Xinjiang Medical Animal Model Research Key Laboratory, No. XJDX1103-2013-05

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被引次数

1

摘要：

文章快速阅读：

文题释义：
间置物关节成形：是切割颞下颌关节区融合骨形成间隙，并且应用自体材料或者异体成型材料充填间隙，比如颞肌筋膜瓣、耳软骨、颊脂垫、关节盘、硅橡胶等，其中颞肌筋膜瓣是颅颌面外科中作为间置物材料应用相对广泛，因其操作方便，有独立的血供，接近术区，面神经损伤率较低等，广受外科医生的青睐。
颞下颌关节强直：简称关节强直，是指关节内发生的病变，最后造成关节内的纤维性或者骨性粘连，也有人称之为真性关节强直。
摘要
背景：目前，国内外关于研究间置物关节成形术与关节重建术治疗颞下颌关节强直的文献不多，结论各异，疗效存在争议。
目的：系统评价颞下颌关节强直患者行间置物关节成形与关节重建的疗效。
方法：计算机检索维普中文科技期刊数据库、万方数据库、PubMed、Ovid、Embase、Clinical Evidence、Cochrance图书馆等，并且结合手工检索。收集2015年12月以前国内外公开发表的间置物关节成形术与关节重建术治疗颞下颌关节强直疗效的临床对照研究。按照纳入标准和排除标准进行筛选文献并对其进行质量评价。运用Stata13.1软件对最大张口度和复发率进行Meta分析。
结果与结论：①纳入文献：15篇；②最大张口度指标：总合并结果为MD= 0.99，95%CI：(-1.43，3.40)，Z=0.80，P=0.424，I2=73.9%；对其亚组分析结果显示，颞肌筋膜瓣组与肋骨肋软骨移植组：MD=0.84，95%CI：(-1.94，3.63)，Z=0.59，P=0.553，I2=82.2%；其他材料组：MD=2.08，95%CI：(-3.03，7.19)，Z=0.80，P=0.426，I2=0.0%；③复发率指标结果：为OR=1.13，95%CI：(0.59，2.15)，Z=0.36，P=0.721，I2=0.0%；④Egger检验和Begg检验结果：均显示不存在发表偏倚；⑤敏感度检验结果显示：所纳入的研究对Meta分析合并效应量无明显影响，Meta分析结果稳健；⑥分析结果提示：应用间置物关节成形与关节重建治疗颞下颌关节强直患者，修复后最大张口度和复发率方面效果等同。受纳入研究数量和质量所限，所得结论尚需开展更多高质量研究予以验证。

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

ORCID: 0000-0002-0173-4837(依沙克江•买买提)

关键词: 组织构建, 骨组织工程, 颞下颌关节强直, 间置物关节成形术, 关节重建术, 颞肌筋膜瓣, 肋骨肋软骨移植, 最大张口度, 复发, meta分析

Abstract:

Abstract
BACKGROUND: At present, studies on interpositional arthroplasty versus reconstruction arthroplasty for temporomandibular joint ankylosis remain scarce and controversial.
OBJECTIVE: To systematically review the efficacy of interpositional arthroplasty versus reconstruction arthroplasty in the treatment of temporomandibular joint ankylosis.
METHODS: A computer-based online search was conducted in VIP, Wangfang, PubMed, Ovid, Embase, Clinical Evidence, Cochrance Library databases before December 2015 to compare the efficacy of interpositional arthroplasty versus reconstruction arthroplasty for temporomandibular joint ankylosis. Meta-analysis of maximal incisal opening and recurrence rate were performed using Stata13.1 software by extracting data from the relevant articles.
RESULTS AND CONCLUSION: A total of 15 studies were included. Meta-analysis results of maximal incisal opening: the total combined result was MD=0.99，95%CI (-1.43, 3.40), Z=0.80, P=0.424, I2=73.9%, and the analysis results from temporomandibular myofascial flap group versus costochondral graft group showed that MD=0.84, 95%CI (-1.94, 3.63), Z=0.59, P=0.553, I2=82.2%; from the other material group MD=2.08, 95%CI (-3.03, 7.19), Z=0.80, P=0.426, I2=0.0%. The recurrence rate: OR=1.13, 95%CI (0.59, 2.15), Z=0.36, P=0.721, I2=0.0%. Egger test and Begg test showed that there were no publication biases in the literatures. The sensitivity test showed that the meta-analysis results were steady because no study influenced the total combined result in the Meta-analysis. These results indicate that interpositional arthroplasty exhibited similar efficacy as reconstruction arthroplasty in the treatment of temporomandibular joint ankylosis. This study was limited by a lack of high-quality studies.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Temporomandibular Joint, Ankylosis, Arthroplasty, Cartilage, Transplantation, Tissue Engineering

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