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目的采用Meta分析法系统评价下颌骨髁突骨折保守治疗和手术治疗的远期疗效。方法以“下颌骨”、“髁突”、“骨折”、“治疗”为关键词,检索Medline、荷兰医学文摘(Embase)、Cochrance图书馆临床对照试验注册资料库(CCTR)和中国期刊网(CNKI)数据库中4种口腔医学杂志,按标准筛选文献,然后进行文献评价和Meta分析。结果共检出172篇相关文献,入选的10篇。10篇论著所含临床样本711例。随诊6个月和2年时,手术组张口度小于非手术组,且差异有统计学意义;随诊1年和2年时,手术组关节疼痛的发生率与非手术组间差异无统计学意义;手术组错骀的发生率小于非手术组,差异有统计学意义。结论年龄>16岁的患者低位髁突骨折有严重移位或脱位时,建议采用手术治疗。与非手术治疗相比,手术治疗能更好地恢复咬合关系。手术组与非手术组术后关节疼痛无差别。张口度的恢复有待进一步研究。
Objective To evaluate the long-term efficacy of conservative treatment and surgical treatment of mandibular condylar fractures by Meta-analysis. Methods Medline, Embase, Cochrance Library CCTR and CNKI were searched with the keywords of “mandibular”, “condylar”, “fracture” and “treatment” CNKI) database of four kinds of stomatology, according to the standard screening of literature, and then the literature evaluation and Meta analysis. Results A total of 172 related articles were found and 10 were selected. 10 articles contained clinical samples of 711 cases. At 6 months and 2 years follow-up, the mouth opening of the operation group was smaller than that of the non-operation group, and the difference was statistically significant. There was no statistical difference between the incidence of joint pain and the non-operation group in the operation group at 1 year and 2 years Significance of the study; The incidence of misdiagnosis in the operation group was less than that in the non-operation group, the difference was statistically significant. Conclusions Patients with age> 16 years of age who have severe dislocation or dislocation of the lower condylar fracture are advised to undergo surgery. Compared with non-surgical treatment, surgical treatment can better restore the occlusal relationship. There was no difference in postoperative joint pain between surgical group and non-surgical group. Mouth recovery needs further study.