联合筋膜鞘悬吊术与额肌瓣悬吊术治疗先天性重度上睑下垂疗效的Meta分析

Efficacy of conjoint fascial sheath and frontalis muscle flap suspension in treatment of congenital severe blepharoptosis: a systematic review and meta-analysis

目的:评估联合筋膜鞘悬吊术与额肌瓣悬吊术治疗先天性重度上睑下垂术后疗效。方法:检索Pubmed、EMbase、Cochrane Library、Web of science、中国知网、万方、维普、cbm等数据库(时间从建库至2020年3月),搜集联合筋膜鞘悬吊术与额肌瓣悬吊术治疗先天性重度上睑下垂患者术后疗效的随机及非随机对照试验。由2名研究者用RevMan 5.3软件根据制定的文献纳入及排除标准筛选文献、提取数据并进行质量评估,制定合适的效果指标并进行Meta分析。结果:共纳入11篇文献,包括661例患者,其中研究组312例,对照组349例。Meta分析结果显示,两组患者术后满意度OR值为4.88,95%CI:2.69,8.85,手术治疗失败率OR值为0.20,95%CI:0.11,0.37,并发症OR值为0.22,95%CI:0.14,0.34,3组数据比较差异有统计学意义(P<0.05)。结论:治疗先天性重度上睑下垂时,联合筋膜鞘悬吊术与额肌瓣悬吊术均能获得较满意疗效,但联合筋膜鞘悬吊术并发症更低,满意度较高。

Objective To evaluate the efficacy of combined fascia sheath suspension(CFS)and frontalis muscle flap suspension in the treatment of severe congenital blepharoptosis.Methods We searched PubMed,EMbase,Cochrane Library,web of science and Chinese Hownet,Wanfang,VIP,CBM and other databases to collect randomized and non-randomized controlled trials comparing the efficacy of CFS and frontalis muscle flap suspension in the treatment of severe congenital ptosis,from the establishment of literature retrieval database to March 2020;two researchers used RevMan 5.3 software to select and exclude the literature,extract the data and evaluate the quality,set up appropriate effect index and conduct Meta-analysis.Results Eleven studies included 661 patients,There were 312 cases in study group and 349 cases in control group.The results of Meta analysis showed that the OR of the two groups was 4.88 with 95%CI(2.69,8.85);the OR of failure rate was 0.20,with 95%CI(0.11,0.37);the OR of complications was 0.22,with 95%CI(0.14,0.34).All three groups of data were statistically significant(P<0.05).Conclusions The available evidence shows that the combined fascia sheath suspension(CFS)is effective in the treatment of severe congenital blepharoptosis compared with frontalis muscle flap suspension,but the complications of CFS are lower and the satisfaction is higher;these findings have yet to be validated by more high-quality studies due to limitations in the quality and quantity of studies included.