特发性黄斑裂孔手术后非面向下体位和面向下体位的 meta 分析  

Face-down posturing after idiopathic macular hole surgery：a meta-analysis

作　　者：夏红和[1] 陈浩宇[1] 彭坤[1] 郑康铿[1] 

机构地区：[1]汕头大学·香港中文大学联合汕头国际眼科中心,515041

出　　处：《中华眼底病杂志》2015年第4期389-393,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的：系统评价特发性黄斑裂孔（IMH）手术后非面向下体位和面向下体位对黄斑裂孔闭合率的影响。方法通过美国国立医学图书馆 PubMed、中国生物医学文献数据库、中国期刊全文数据库、维普中文医学期刊全文数据库,选取手术后非面向下体位（非面向下体位组）、面向下体位（面向下体位组）的临床对照研究进行 meta 分析。共纳入符合条件的文献9篇。其中,非面向下体位组285只眼,其中裂孔直径≤400μm 小裂孔者145只眼,〉400μm 大裂孔者104只眼；面向下体位组303只眼,其中小裂孔者141只眼,大裂孔者124只眼。应用 RevMan 4.2软件对各纳入研究结果进行异质性检验。采用相应数学模型进行数据合并,漏斗图对发表偏倚进行评价。结果Meta 分析结果显示,非面向下体位组和面向下体位组患者黄斑裂孔闭合率比较,差异有统计学意义[总比值比（OR）=0.47,95%可信区间（CI ）为0.26~0.84；P =0.01]。两组间小裂孔者裂孔闭合率比较,差异无统计学意义（OR=0.45,95%CI 为0.13~1.51；P =0.20）；大裂孔者闭合率比较,差异有统计学意义（OR=0.35,95%CI 为0.17~0.75；P =0.006）。结论黄斑裂孔直径≤400μm 者,是否采取面向下体位对裂孔闭合率无影响；〉400μm 者,采取面向下体位可提高裂孔闭合率。Objective To evaluate the full thickness idiopathic macular hole （IMH）closure rates in patients positioning non-supine （NSP）compared with patients positioning face-down （FDP）.Methods A computerized search was conducted in the PubMed, Chinese Biomedical Database, China National Knowledge Infrastructure,and VIP database.All the included studies were divided into NSP and FDP group.A total of 9 papers were included in this meta analysis,including 285 eyes （145 eyes with small hole≤400 μm,104 eyes with large hole 〉400 μm）in NSP group and 303 eyes （141 eyes with small hole and 124 eyes with large hole ）.RevMan 4.2 software was applied for investigating heterogeneity and meta-analysis,and the risk of publication bias was evaluated.Results Meta analysis indicated that there was statistical significance on closure rates betwen NSP and FDP group [odds ratio （OR ）= 0.47, 95%confidence interval （CI ）0.26-0.84,P =0.01].The difference of closure rates in small macular hole eyes between NSP and FDP group was statistically significant （OR=0.45,95%CI 0.13-1.5 1;P =0.20）.The difference of closure rates in large macular hole eyes between NSP and FDP group was statistically significant （OR=0.35,95%CI 0.1 7-0.75;P =0.006）.Conclusion NSP is equally effective as strict FDP in the repair of small macular hole.Post-operative FDP may improve the macular hole closure rates for holes larger than 400 μm.

关 键 词：视网膜穿孔/外科学 俯卧位 META 分析 

分 类 号：R779.6[医药卫生—眼科]