腮腺区域性切除术在治疗腮腺浅叶良性肿瘤中的系统评价

The effect of partial superficial parotidectomy on benign parotid tumor of superficial lobe: a systematic review

目的系统评价腮腺区域性切除术治疗腮腺浅叶良性肿瘤的效果。方法计算机检索MEDLINE、EMbase、Cochrane图书馆、CNKI、CMCI、VIP、CBM、WANGFANG数据库中关于腮腺区域性切除术治疗腮腺浅叶良性肿瘤的文献,由2名评价者独立进行文献质量评价和资料提取后,采用RevMan5.1软件进行Meta分析。结果共纳入24个研究,腮腺区域性切除术(PSP)组1 111例和腮腺浅叶切除术(SP)组1 095例患者,Meta分析结果显示:PSP术式能减少手术时间(MD=-28.55,95%CI:10.43-14.78;P<0.000 01),降低术后暂时性面瘫、味觉出汗综合征、涎瘘的发生率[(OR=0.27,95%CI:0.20-0.35;P<0.000 01)、(OR=0.20,95%CI:0.13-0.32;P<0.000 01)、(OR=0.29,95%CI:0.15-0.55;P=0.000 2)],差异有统计学意义,降低术后永久性面瘫的发生率(OR=0.34,95%CI:0.11-1.05;P=0.06),但差异无统计学意义,两组的术后复发率没有统计学差异(OR=1.23,95%CI:0.54-2.81;P=0.62)。结论 PSP术式手术时间短,术后并发症发生率低,疗效可靠,可作为腮腺浅叶良性肿瘤治疗的首选术式。

Objective To evaluate the effect of partial superficial parotidectomy on benign parotid tumor of superficial lobe. Methods The literatures were retrieved with computers about partial superficial parotidectomy for benign parotid tumor of superficial lobe from MEDLINE,EMbase, Cochrane Library, CNKI, CMCI, VIP, CBM, WANGFANG database. The data extraction and quality assessment were analyzed by two reviewers independently using software RevMan5.1. Results 24 studies were included,and there were 1 111 ca- ses in PSP group and 1 095 cases in SP group. Meta analysis showed：PSP surgical procedures can reduce the operation time （MD = - 28.55,95 % CI： 10.43 - 14.＇78 ; P 〈 0. 000 01 ） , and reduce the incidence of temporary facial paralysis, Frey＇s syndrome, salivary fis- tula [ （OR =0.27,95% CI：0.20 -0.35; P 〈0. 000 01） ,（OR =0.20,95% CI：0.13 -0.32; P 〈0. 000 01） , （OR =0.29,95% CI： 0.15 -0.55; P = 0. 000 2） ] , and the difference was statistically significant. It can also reduce the incidence of permanent facial paral- ysis （ OR = 0.34,95 % CI：0. 11 - 1.05 ; P = 0.06） , but the difference was not statistically significant. In terms of the recurrence rate, there was no statistically significant difference between the two groups （ OR = 1.23,95% CI：0. 54 - 2.81 ; P = 0.62 ）. Conclusions The operative time of PSP is shorter. PSP is effective in shortening the operation time, reducing the incidence of postoperative complications and its curative effect is reliable,thus it can be used as the treatment of choice for benign superficial lobe of parotid.