微血管吻合器与手工缝合在游离皮瓣修复软组织缺损中的对比研究:一项基于PRISMA原则的Meta分析  

Comparative study of microvascular anastomostic device and hand-sewn in free flap repair of soft tissue defects:a Meta analysis based on PRISMA principle

作　　者：文虹杰[1] 李灿章[1] 李俊男[1] 徐永清[2] WEN Hongjie;LI Canzhang;LI Junnan;XU Yongqing(Department of Orthopaedic and Trauma Surgery,The Second People's Hospital of Yunnan Province,Kunming 650021,China;Department of Orthopaedic Surgery,920th Hospital of Joint Logistics Support Force of P.L.A.,Kunming 650032,China)

机构地区：[1]云南省第二人民医院骨与创伤外科,昆明650021 [2]中国人民解放军联勤保障部队920医院骨科,昆明650032

出　　处：《中华显微外科杂志》2021年第1期36-42,共7页Chinese Journal of Microsurgery

基　　金：国家科技部重点研发计划项目(2017YFC1103904)。

摘　　要：目的比较游离皮瓣修复术中应用微血管吻合器(MAD)与手工缝合(HS)的效果和安全性。方法检索Pubmed、Embase、CNKI、万方、CBM和维普等数据库,收集1950年1月至2019年10月国内外正式刊物上公开发表的有关在游离皮瓣修复软组织缺损中采用MAD与HS对比的研究,严格评价纳入研究的文献质量及提取相关资料,运用RevMan 5.3软件统计分析所有相关数据。结果共纳入15项研究,包含5539例患者。资料分析显示,与HS组相比,MAD组静脉吻合时间明显较短(SMD=-5.46,95%CI:-7.50,-3.41,P<0.001),动脉吻合时间较短(SMD=-5.16,95%CI:-9.61,-0.71,P=0.02),血管危象出现率较低(RR=0.49,95%CI:0.34,0.70,P<0.001),皮瓣坏死率较低(RR=0.52,95%CI:0.32,0.86,P=0.01),两组间差异均有统计学意义(P<0.05)。结论对于游离皮瓣修复软组织缺损,应用MAD与HS相比,在动脉和静脉吻合时间、血管危象以及皮瓣坏死率方面可能有优势。Objective To compare the efficacy and safety between microvascular anastomostive device(MAD)and hand-sewn(HS)in free flap reconstruction.Methods Databases in Pubmed,Embase,CNKI,Wanfang,CBM and Weipu etc.The comparative study of MAD device and manual suture in free flap repair of soft tissue defects published in domestic and foreign official journals from January,1950 to October,2019 was collected.The quality of the included studies was strictly evaluated and relevant data were extracted.Revman 5.3 software was used to analyze all relevant data.Results Fifteen trials with 5539 patients were included.There was significant difference between MAD and HS in time of venous anastomoses(SMD=-5.46,95%CI:-7.50,-3.41,P<0.001),time of artery anastomoses(SMD=-5.16,95%CI:-9.61,-0.71,P=0.02),vascular crisis(RR=0.49,95%CI:0.34,0.70,P<0.001)and flap necrosis(RR=0.52,95%CI:0.32,0.86,P=0.01),the difference between the 2 groups was statistically significant(P<0.05).Conclusion According to the analyses of the pooled results of MAD group and HS group,the data tend to suggest that MAD is superior to HS in the reconstruction with free flap.

关 键 词：微血管吻合器 手工缝合 软组织缺损 游离皮瓣 荟萃分析 

分 类 号：R622[医药卫生—整形外科]