植入式多普勒监测皮瓣血运障碍准确性的系统评价  

Systemic review of the accuracy of implantable Doppler probe for free flap monitoring

作　　者：陈琛[1] 杜元敏[1] 陈婧婧[1] 陆巍[2] 

机构地区：[1]南京大学医学院附属鼓楼医院整形烧伤科,210008 [2]南京大学医学院附属鼓楼医院护理部,210008

出　　处：《中华现代护理杂志》2016年第34期4967-4972,共6页Chinese Journal of Modern Nursing

摘　　要：目的：评价植入式多普勒早期发现术后游离皮瓣血运障碍的准确性。方法计算机检索The Cochrane Library,MEDLINE,IFCC,BIOSIS Previews,中国知网、万方、中国生物医学文献数据库（ CBM）中关于植入式多普勒监测皮瓣血运的研究,由2名系统评价员独立进行文献筛选,采用Cochrane指定文献评价工具进行文献质量评价,提取资料后使用Stata软件计算综合灵敏度、特异度、似然比、诊断优势比,绘制森林图和SROC曲线。结果共检索文献568篇,最终纳入9篇,共1136例患者。 Meta分析显示,植入式多普勒用于监测皮瓣血运障碍的合并灵敏度为0.93（0.67-0.99）,合并特异度为0.97（0.96-0．98）,合并阳性似然比为36.1（23.9--54.6）,合并阴性似然比为0.07（0.01-0.4）,合并诊断优势比为498（79-3137）,SROC曲线下面积0.98（0.96-0.99）。结论植入式多普勒用于监测皮瓣血运敏感度及特异度均较高,特别适用于发现早期皮瓣血运障碍,提高坏死皮瓣挽救率。Objective To assess the accuracy of the implantable Doppler probe for free flap monitoring. Methods Researches about the implantable Doppler probe for free flap monitoring were retrieved by keywords retrieval in Cochrane, Medion, IFCC, BIOSIS Previews databases and Chinese national knowledge infrastructure （ CNKI） , Wanfang and Chinese biomedical medicine （ CBM） literature database. Two reviewers independently screened the literature, and the Cochrane specified literature evaluation tools were used for quality assessment of the literature. After extracting the data, the Stata software was used to calculate the comprehensive sensitivity, specificity, likelihood ratio, diagnostic odds ratio, and drawing the forest map and SROC curve. Results A total of 568 literatures were retrieved, 9 were included in the study, and the total sample size is 1 136. Meta analysis showed：the sensitivity of implantable Doppler probe for free flap monitoring was 0.93 （0.67-0.99）, the pooled specificity was 0.97 （0.96-0.98）, the pooled positive likelihood ratio was 36.1 （23.9--54.6）, the negative likelihood ratio was 0.07 （0.01-0.4）, and pooled diagnostic odds ratio was 498 （79-3 137）, and the area under the SROC curve was 0.98 （0.96-0.99）. Conclusions The implanted Doppler probe was used to monitor the sensitivity and specificity of free flap monitoring, and they are all high, especially for the detection of early free flap blood supply, and the improvement of the salvage rate of the necrotic flap.

关 键 词：植入式多普勒 皮瓣血运 系统评价 

分 类 号：R473.6[医药卫生—护理学]