鼻中隔黏膜瓣重建鼻咽部放疗后坏死有效率的Meta分析  

Nasal septum mucosal flap for postoperative reconstruction of post-radiation nasopharyngeal necrosis:a Meta-analysis

作　　者：侯思源 王振霖[1] 齐岩[1] 刘俊其[1] 张思远 刘绍昆 HOU Siyuan;WANG Zhenlin;QI Yan;LIU Junqi;ZHANG Siyuan;LIU Shaokun(Department of Otolaryngology Head and Neck Surgery,Skull Base Center,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院耳鼻咽喉头颈外科颅底外科中心,北京100053

出　　处：《中国耳鼻咽喉颅底外科杂志》2022年第6期79-86,共8页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2013-3-093)。

摘　　要：目的系统评价鼻咽癌患者应用鼻中隔黏膜瓣重建鼻咽部放疗后坏死(PRNN)清创术后鼻咽部缺损的有效性。方法应用计算机检索Pubmed、Cochrane Library、Embase、Web of Science等英文数据库,以及中国知网(CNKI)、万方(WANFANG)、维普(VIP)等中文数据库,检索时间为自数据库建立至2021年2月1日,检索鼻中隔黏膜瓣修复PRNN术后鼻咽部缺损的临床研究。由两位研究者独立筛选文献、提取资料后,应用RStuido软件进行效应量分析。结局指标为鼻中隔黏膜瓣重建鼻咽部缺损的有效率。此外,搜索并分析仅以鼻咽坏死组织清创治疗PRNN的研究作为参考。结果初次检索获得文献1005篇,根据纳入及排除标准,最终纳入5篇单臂回顾性研究,共145例患者,鼻中隔黏膜瓣重建鼻咽部缺损成功率为84%(95%CI=[0.72,0.96],I 2=74%)。同时,检索到9篇仅以鼻咽坏死组织清创治疗PRNN的研究,其上皮化率为47%(95%CI=[0.31,0.62],I 2=94%)。结论鼻中隔黏膜瓣作为有效的修补材料,可用于PRNN清创手术中鼻咽部缺损的重建,需要更多的前瞻性队列研究或随机对照试验以进一步研究。Objective To systematically evaluate the effectiveness of nasal septum mucosal flap for postoperative reconstruction of post-radiation nasopharyngeal necrosis(PRNN).Methods English databases,such as PubMed,Cochrane Library,Embase,Web of Science,and Chinese databases,such as CNKI,Wanfang,VIP were searched by computer.The retrieval time was from the establishment of the database to Feb 1,2021.To search the clinical studies of repairing nasopharynx defect after operation of PRNN with nasal septum mucosal flap.Two researchers independently screened the literatures and extracted the data,then the analysis was carried out using the software Rstudio.The outcome index was the effectiveness of nasal septum mucosal flap in repairing nasopharyngeal defect.In addition,studies of PRNN treated by debridement of nasopharyngeal necrotic tissue were searched and analyzed as reference.Results A total of 1005 literatures were retrieved initially.According to the inclusion and exclusion criteria,5 single-arm studies were included,including 145 patients.The success rate of reconstruction of nasopharyngeal defects by nasal septum mucosal flap was 84%(95%CI=[0.71,0.93],I 2=53.75%).At the same time,9 studies of PRNN treated by debridement of nasopharyngeal necrotic tissue revealed an epithelization rate of 47%(95%CI=[0.31,0.62],I 2=94%).Conclusion Nasal septum mucosal flap can be used as an effective repair material to reconstruct defects after debridement of PRNN.More prospective cohort studies or randomized controlled trials are needed for further study.

关 键 词：鼻中隔黏膜瓣 重建 鼻咽癌 META分析 

分 类 号：R739.63[医药卫生—肿瘤]