手术治疗颅颌面部骨纤维发育不良对视力影响的系统评价

Effect of surgical therapy for patients with cranio-maxillo-facial fibrous dysplasia on visual acuity: a systematic review

目的:探讨手术治疗颅颌面部骨纤维发育不良对患者视力的影响。方法:计算机检索PubMed、Web of Science、Cochrane图书馆和Cochrane临床试验注册中心、中国知网、维普数据库和万方数据库。纳入对颅颌面部骨纤维发育不良患者行手术治疗的研究,以未出现视力损伤患者为试验组,出现视力损伤患者为对照组,提取手术后出现视力损伤患者数合并数据进行meta分析。结果:采用固定效应模型进行meta分析,未出现视力损伤时,进行手术治疗完全不会增加视力损伤的发生[OR=0.39,95%CI(0.18~0.86),P=0.02],各研究之间同质性良好[Chi2=8.63,df=9(P=0.47);I2=0%],且研究不存在发表偏倚。结论:手术治疗颅颌面部骨纤维发育不良并不会增加患者视力受损的可能性。

PURPOSE: To investigate the clinical effect and safety of surgical operation for patients who suffered from cranio-maxillo-facial fibrous dysplasia(CFD) on the aspect of visual acuity. METHODS: PubMed, Web of Science,Cochrane Library, Cochrane Clinical Trials Registration Center, CNKI, Wanfang database and VIP database were searched respectively and successively by computer up to now. All the patients who suffered from CFD were included, and the ones without visual impairment were defined as the experimental group, the other ones who got visual damage were defined as the control group. The total number of patients with visual impairment because of therapeutic surgery was extracted, and the data were processed in the way of meta-analysis. RESULTS: Fixed effect model was used for meta-analysis because there was good homogeneity between the studies(Chi~2=8.63, df=9, P=0.47, I2=0%). Patients who had not visual impairment accepted surgery for their CFD as treatments and surgery did not increase the incidence of visual impairment [ OR =0.39,95%CI(0.18-0.86),P=0.02]. There was no publication bias among the studies as well. CONCLUSIONS: Applying surgical operation for the treatment of CFD may not increase the possibility of visual impairment.