颞肌外与颞肌下颅骨成形术疗效的Meta分析

Outside temporalis versus under temporalis for cranioplasty: a meta-analysis of curative effects

目的比较颞肌外与颞肌下两种不同颅骨成形术式的疗效。方法计算机检索PubMed、Medline、EMbase等英文数据库及中国知网、万方、维普等中文数据库,收集对比颞肌下与颞肌外两种颅骨成形术疗效的研究,使用Rev Man5.3软件对相关数据进行Meta分析。结果共纳入11篇相关研究共726例,其中颞肌外组367例,颞肌下组359例。Meta分析结果显示:两种术式术后癫痫发生率、脑内血肿发生率无统计学差异(P>0.05);颞肌外组手术时间、术中出血少于颞肌下组(P<0.05),而术后咀嚼受限发生率及外观异常发生率大于颞肌下组(P<0.05)。结论颞肌外颅骨成形术较颞肌下成形术的手术时间及术中出血较少,但术后易发生咀嚼受限及外观异常。

Objective To evaluate the effectiveness and the safety of surgery outside temporalis and one under temporalis for cranioplasty in the patients with skull defect.Methods A literature search of data banks including PubMed, Medline, EMbase, CNKI,Wanfang Datebase, VIP was made for the original articles about surgery outside temporalis versus one under temporalis for cranioplasty.Meta analysis of the data was performed by RevMan5.3 software.Results Eleven articles involving 726 patients, of whom, 367 received cranioplasty outside temporalis and 359 received cranioplasty under temporalis were derived from the data banks. Meta-Analysis revealed that the operative duration and the intraoperative blood loss volume were significantly less, and the postoperative chew-limited rate and abnormal appearance rate were significantly higher in the patients receiving the cranioplasty outside temporalis than those in the patients receiving the cranioplasty under temporalis（P〈0.05）. There were insignificant differences in the postoperative seizure rate and the intracranial hematoma rate between the two groups（P〈0.05）.Conclusions The cranioplasty outside temporalis may require less operative time and cause less intraoperative blood loss, but it may more easily cause limited chew and abnormal appearance compared to the cranioplasty under temporalis in the patients with skull defects receiving craniotomy.