同期牙种植对血管化腓骨瓣修复颌骨缺损存活率的影响：系统评价与荟萃分析

中国口腔医学继续教育杂志 ›› 2022, Vol. 25 ›› Issue (6): 354-360.

同期牙种植对血管化腓骨瓣修复颌骨缺损存活率的影响：系统评价与荟萃分析

吴沉洲, 李春洁^*

四川大学华西口腔医院头颈肿瘤外科

出版日期:2022-11-30 发布日期:2022-11-28
通讯作者: ^*李春洁,联系方式 028-85501428,电子邮箱 lichunjie07@qq.com,通讯地址四川省成都市武侯区人民南路三段14号,610041

Online:2022-11-30 Published:2022-11-28

摘要/Abstract

摘要： 目的: 通过循证医学的方法,评估修复颌骨缺损时同期种植对血管化腓骨瓣游离移植存活率的影响。方法: 检索万方、维普、Medline、EMBASE、Cochrane library数据库。应用美国医疗保健研究与质量局（Agency for Healthcare Research and Quality,AHRQ）横断面研究评价标准,评估纳入文献的质量。应用随机效应模型对腓骨瓣存活率进行荟萃分析。针对同期植入种植体数目、颌骨重建手术部位进行亚组分析。结果: 共纳入5项病例系列研究,涉及104例患者。纳入研究的AHRQ评分均大于7。结果显示,同期种植后,血管化腓骨瓣的存活率为94.20%,95%置信区间（91.88%, 95.89%）。平均植入3颗以上种植体的亚组,腓骨存活率为92.87%,95%置信区间（91.92%,93.71%）;而平均种植体数目介于2~3颗/人的亚组,腓骨存活率为95.73%,95%置信区间（95.50%,95.99%）。仅纳入下颌骨重建患者的亚组,腓骨存活率为94.65%,95%置信区间（92.06%,96.42%）;对于同时纳入上颌骨、下颌骨重建患者的亚组,腓骨存活率为92.87%,95%置信区间（91.92%,93.71%）。结论: 修复颌骨缺损时同期种植不会显著降低血管化腓骨瓣游离移植存活率。植入种植体的数量可能会影响术后腓骨瓣的存活率。本系统综述纳入研究数量有限,涉及患者人数较少,以上结论仍需更多研究的证实。

关键词: 颌骨重建, 血管化腓骨瓣, 同期种植, 皮瓣存活率, meta分析

吴沉洲, 李春洁. 同期牙种植对血管化腓骨瓣修复颌骨缺损存活率的影响：系统评价与荟萃分析[J]. 中国口腔医学继续教育杂志, 2022, 25(6): 354-360.

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