内镜辅助手术治疗颅缝早闭症可行性的Meta分析  

Endoscopic-assisted Surgery for Craniosynostosis: A Meta-analysis of Effectiveness

作　　者：熊钰祯 陈雪梅 梁杰 张刚 XIONG Yu-zhen;CHEN Xue-mei;LIANG Jie;ZHANG Gang(Guangdong Medical University,Zhanjiang 524000,Guangdong,China;Department of Plastic Surgery,Affliated Hospital ofGuangdong Medical University,Zhanjiang 524000,Guangdong,China)

机构地区：[1]广东医科大学,广东湛江524000 [2]广东医科大学附属医院整形外科,广东湛江524000

出　　处：《中国美容医学》2019年第6期80-84,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:评价内镜辅助手术与传统开放手术比较治疗颅缝早闭症的可行性与安全性。方法:计算机检索Medline、Embase、TheCochraneLibrary、Pubmed、中国期刊全文数据库(CNKI)以及万方数据库中有关内镜辅助手术与传统开放手术比较治疗颅缝早闭症的临床对照试验,检索时间均为自建库至2018年11月10日。由两位研究者独立评价并交叉核对纳入文献的方法学质量,并采用Cochrane协作网专用软件ReviewManager5.3软件进行Meta分析。结果:未获得随机对照试验,8个病例对照试验被纳入,合计1 962例患者,其中801例行内镜辅助手术,1 161例行传统开放手术。Meta分析结果显示:内镜辅助手术在并发症发生率[OR=0.57,95%CI:0.44~0.74,P<0.0001]、输血率[RR=0.48,95%CI:0.26~0.91,P=0.02]、术中出血量[MD=-158.70,95%CI:-257.47^-59.93,P=0.002]、手术时间[MD=-101.32,95%CI:-138.15^-64.49,P<0.00001]方面与传统手术治疗颅缝早闭症相比,差异均具有统计学意义。结论:当前临床研究证据表明,内镜辅助治疗颅缝早闭症作为一种微创手术,与传统开放手术相比,具有术中出血量少、手术时间短、术后并发症少、创伤小等优点,内镜辅助手术有望成为治疗颅缝早闭症的首选治疗方案。Objective To evaluate the feasibility and safety of endoscopic assisted surgery compared with traditional open surgery in the treatment of craniosynostosis. Methods clinical controlled trials of endoscopically-assisted surgery in the treatment of craniosynostosis were searched by computers, which was in comparison with open surgery in Medline, Embase, The Cochrane Library, Pubmed, CNKI and Wanfang databases, the retrieval time was from this period of self-established database to December 10, 2018,and methodological quality of the included literature was independently evaluated and cross-checked by two researchers.Meta-analysis was performed using Revman5.3, a special Cochrane collaboration software. Results Eight studies were included in the analysis,and represented 1 962 patients, including 801 cases of endoscopic assisted surgery and 1 161 cases of traditional open surgery. Meta analysis results showed that compared with traditional surgery for craniosynostosis, endoscopically-assisted surgery had statistically significant differences in complications[OR=0.57, 95%CI: 0.44~0.74, P<0.0001],transfusion rate[RR=0.48,95%CI:0.26~0.91,P=0.02]、operation time [MD=-101.32, 95%CI:-138.15^-64.49, P<0.00001]、Blood loss[MD=-158.70,95%CI:-257.47^-59.93, P=0.002]. Conclusion The current clinical research evidence indicates that endoscopic assisted surgery for craniosynostosis is a minimally invasive surgery. In contrast with traditional open surgery, endoscopic assisted surgery has the advantages of less intraoperative blood loss, shorter operation time, fewer postoperative complications and less trauma, which is expected to be the first choice for the treatment of craniosynostosis.

关 键 词：颅缝早闭症 内镜辅助 微创 开放手术 META分析 临床对照试验 

分 类 号：R622[医药卫生—整形外科]