额肌瓣悬吊术与上睑提肌缩短术治疗上睑下垂有效性及安全性的Meta分析  

Efficacy and Safety of Frontalis Muscle Flap Suspension and Shortening of Musculus Levator Palpebrae Superioris in the Treatment of Blepharoptosis:A Meta Analysis

作　　者：刘剑 孙家明[1] LIU Jian;SUN Jia-ming(Department of Plastic Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属协和医院整形外科,湖北武汉430022

出　　处：《中国美容医学》2021年第3期1-5,共5页Chinese Journal of Aesthetic Medicine

基　　金：国家重点研发计划(编号:2019YFA0110500)。

摘　　要：目的:比较额肌瓣悬吊术与上睑提肌缩短术治疗不同程度上睑下垂的有效性及安全性。方法:通过中国知网、万方数据库、维普、中国生物医学文献服务系统、PubMed、EMBASE和Cochrane图书馆,系统检索与额肌瓣悬吊术及上睑提肌缩短术治疗上睑下垂相关的文章。利用STATA 12.0软件,使用随机效应模型,计算纳入的各项研究比值比(Odds ratio,OR)及95%可信区间(Confidence intervals,CI),并进行合并分析。结果:本次纳入19篇文献,共1588例患者。结果显示:利用额肌瓣悬吊术治疗不同程度上睑下垂的有效性与上睑提肌缩短术相比差异无统计学意义(OR=0.97,95%CI:0.50~1.86),但是并发症发生率较高(OR=2.34,95%CI:1.19~4.61),安全性较差。两种术式应用于中、重度上睑下垂治疗,额肌瓣悬吊术的有效性与上睑提肌缩短术相比差异无统计学意义(OR=0.73,95%CI:0.35~1.53),但是并发症发生率进一步升高(OR=3.17,95%CI:1.51~6.64)。结论:额肌瓣悬吊术治疗不同程度上睑下垂的临床疗效与上睑提肌缩短术相当,但是后者的并发症发生率更低,安全性较高。Objective To compare the efficacy and safety of frontalis muscle flap suspension and shortening of musculus levator palpebrae superioris in the treatment of different degrees of blepharoptosis.Methods We systematically performed a search for published studies on CNKI,Wanfang Database,VIP Database,SinoMed,PubMed,EMBASE,and the Cochrane Library.Studies that reported the treatment of blepharoptosis with frontalis muscle flap suspension and shortening of musculus levator palpebrae superioris were included.A random-effects model was applied to obtain the pooled odds ratio(OR)and 95%confidence intervals(CI)by STATA12.0.Results 19 articles(1588 patients)were included in this study.There was no significant difference in the efficacy of shortening of musculus levator palpebrae superioris and frontalis muscle flap suspension for different degrees of ptosis(OR=0.97,95%CI:0.50-1.86).However,in terms of safety,frontalis muscle flap suspension had a higher incidence of complications(OR=2.34,95%CI:1.19-4.61).Further analysis of the two methods applied to the moderate and severe ptosis had shown that the efficacy of frontalis muscle flap suspension was still not significantly different from that of shortening of musculus levator palpebrae superioris(OR=0.73,95%CI:0.35-1.53),but the incidence of complications was further increased(OR=3.17,95%CI:1.51-6.64).Conclusion The study indicated that the efficacy of frontalis muscle flap suspension in the treatment of blepharoptosis was comparable to shortening of musculus levator palpebrae superioris.However,the latter was safer and more reliable.

关 键 词：额肌瓣悬吊术 上睑提肌缩短术 上睑下垂 META分析 有效性 安全性 并发症 

分 类 号：R622[医药卫生—整形外科]