可吸收内固定系统在颌面部骨折中应用的系统评价与Meta分析  

The clinical application of absorbable internal fixation system in maxillofacial fractures: systematic review and Meta-analysis

作　　者：刘航航[1] 吴沉洲 潘唯一[1] 苏志飞 段泽西[1] 石龙[1] 李春洁[1,2] 

机构地区：[1]口腔疾病研究国家重点实验室,四川省成都市610041 [2]四川大学华西口腔医院头颈肿瘤外科,四川省成都市610041

出　　处：《中国组织工程研究》2015年第52期8509-8516,共8页Chinese Journal of Tissue Engineering Research

基　　金：2014年四川大学青年教师科研启动基金资助项目(2014SCU11032)~~

摘　　要：背景:目前,国际上针对可吸收内固定系统与钛金属内固定系统在颌面部骨折中的应用比较已有较多临床研究,但尚无针对该研究方向的系统评价与Meta分析。目的:通过系统评价和Meta分析方法比较可吸收材料内固定系统和钛金属材料内固定系统在颌面部骨折中的应用效果。方法:采用主题词检索方法,电子检索Medline、Embase、Cochrane图书馆临床随机对照试验库、中国生物医学文献数据库和中国学术期刊网络出版总库,有关可吸收内固定系统和钛金属内固定系统在颌面部骨折中应用的临床随机对照试验和临床对照试验,应用Revman 5.3软件进行Meta分析。结果与结论:共纳入13篇研究,共涉及患者1 718例。Meta分析结果显示:可吸收内固定系统组植入物移除率显著低于钛金属组(P=0.000 2),两组骨折I期愈合率、骨折断端固位不良发生率、长期并发症发生率比较差异均无显著性意义。表明可吸收内固定系统应用于颌面部骨折具有良好的有效性及安全性,并且可降低二次手术移除植入物的比例,该结论仍需更多临床随机对照试验支持。BACKGROUND： There are numerous clinical studies on comparing absorbable internal fixation system and titanium metal internal fixation system in maxillofacial fractures; however, the systematic reviews and Meta-analysis in this field are rare. OBJECTIVE： To compare the clinical effect of absorbable internal fixation system and titanium internal fixation system in maxillofacial fractures through systematic review and Meta-analysis. MATERIALS AND METHODS： The randomized controlled trials and controlled clinical trials regarding the application of absorbable internal fixation system and titanium internal fixation system in maxillofacial fractures were electronically retrieved from Medline, Embase, the Cochrane Central Register of Controlled Trials, China Biology Medicine disc, and China Academic Journal Network Publishing Database using the keywords. Meta-analysis was conducted using Revman 5.3 software. RESULTS AND CONCLUSION： Thirteen clinical studies were included, and totally 1 718 patients were involved. The Meta-analysis results showed that the removal rate of implants in the absorbable internal fixation system group was significantly lower than that in the titanium internal fixation group（P=0.000 2）; there were no significant differences in the healing rate of fracture I stage, the incidence of insufficient fixation in fracture site and the incidence of long-term complications between these two groups. These results demonstrate that the efficiency and safety of absorbable internal fixation system in maxillofacial fracture is satisfactory, and can reduce the proportion of secondary surgical removal of the implant. More randomized controlled trials should be conducted to confirm this conclusion.

关 键 词：可吸收性植入物 骨折 内固定器 循证医学 组织工程 生物材料 骨生物材料 钛金属内固定系统 颌面损伤 内固定 

分 类 号：R318[医药卫生—生物医学工程]