国内应用异种脱细胞真皮基质预防味觉出汗综合征发生的Meta分析

A Meta-analysis on the Application of Heterogeneous Acellular Dermal Matrix to Prevent the Occurrence of Gustatory Sweating Syndrome in China

目的系统评价2013—2021年国内于腮腺术后应用异种脱细胞真皮基质(acellular dermal matrix,ADM)预防味觉出汗综合征发生的效果。方法全面检索2013年1月—2021年12月中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)中有关腮腺肿物切除术后应用异种ADM预防味觉出汗综合征的随机/半随机对照试验,提取资料和质量评估均由2名研究者独立完成,最终选入14篇研究,共计1405例受试者,采用RevMan 5.3软件对资料进行Meta分析。结果Meta分析结果显示,主观方面评价有统计学意义[RR=0.13,95%CI为(0.09,0.19)],合并效应量的检验(Z=10.74,P<0.00001);客观方面评价有统计学意义[RR=0.19,95%CI为(0.12,0.28)],合并效应量的检验(Z=8.36,P<0.00001)。因异质性较大,故行敏感性分析,结果依旧保持一致。结论腮腺手术后,植入异种ADM能有效减少腮腺术后味觉出汗综合征的发生。但国内的研究仍需要提高随机对照试验的设计水准,以提供更多的具有长期随访结果的随机对照试验,增强长时间预后效果的证据性。

Objective To systematically evaluate the effect of applying heterogeneous acellular dermal matrix(ADM)to prevent the occurrence of gustatory sweating syndrome after parotid surgery in China from 2013 to 2021.Methods A comprehensive search January 2013 to December 2021 of randomized/semi-randomized controlled trials on the use of heterogeneous ADM for the prevention of gustatory sweating syndrome after parotidectomy was conducted in the China Journal Full Text Database(CNKI),Chinese Science and Technology Journal Database(VIP),Wanfang Database,and China Biomedical Literature Database(CBM).Extraction of data and quality assessment were done independently by 2 investigators,and 14 studies with a total of 1405 subjects were finally selected,and the data were Metaanalyzed using RevMan 5.3 software.Results The results of meta-analysis showed that the subjective evaluation had statistical significance[RR=0.13,95%CI(0.09,0.19)],combined effect size test(Z=10.74,P<0.00001);Objective evaluation had statistical significance[RR=0.19,95%CI(0.12,0.28)],combined effect size test(Z=8.36,P<0.00001).Due to the large heterogeneity,sensitivity analysis was performed,and the results remained consistent.Conclusion Implantation of heterogeneous ADM after parotid gland surgery can effectively reduce the incidence of sweat gustation syndrome after parotid gland surgery.However,domestic studies still need to improve the design level of randomized controlled trials,so as to provide more randomized controlled trials with long-term follow-up results and enhance the evidence of long-term prognostic effect.