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目的:系统评价并比较脱细胞真皮基质(ADM)和腮腺咬肌筋膜下翻瓣预防Frey综合征的有效性。方法:检索2001—2013年间万方数据库、中国学术期刊全文数据库(CNKI)、维普数据库(VIP)及中国生物医学文献数据库(CBM)所收录的有关腮腺咬肌筋膜下翻瓣和(或)ADM预防腮腺良性肿瘤术后Frey综合征的随机对照研究(RCT)。采用Review Manager 5.2软件对纳入文献的数据进行meta分析。结果:共纳入RCT 16篇。Meta分析显示,采用腮腺咬肌筋膜下翻瓣和术中植入ADM,术后Frey综合征的主观发生率分别降低71%和87%,客观发生率分别降低64%和85%。在主观发生率降低方面,两者之间无显著差异,而术中植入ADM比腮腺咬肌筋膜下翻瓣能更为有效地降低术后Frey综合征的客观发生率,差异具有显著性。结论:本研究显示,腮腺良性肿瘤一般可通过腮腺咬肌筋膜下翻瓣预防术后Frey综合征的发生;而对于无法保留腮腺咬肌筋膜者,同期植入ADM,同样能达到预防术后Frey综合征的目的。
OBJECTIVE: To systematically evaluate and compare the effectiveness of acellular dermal matrix (ADM) and parotidectomy flap in the prevention of Frey’s syndrome. Methods: The data of parotid fascia submucus flap and / or flap collected from Wanfang database, CNKI, VIP and CBM database from 2001 to 2013 were searched. ADM Randomized Controlled Trial (RCT) for Prevention of Postoperative Frey Syndrome in Parotid Tumor. Review Manager 5.2 software was used to meta-analyze the data included in the literature. Results: A total of 16 RCTs were included. Meta-analysis showed that suboptimal parotid fascia flap and intramedullary ADM were used to reduce the subjective frequency of postoperative Frey syndrome by 71% and 87%, respectively. The objective incidence rates were reduced by 64% and 85% respectively. There was no significant difference between the two groups in decreasing the subjective incidence, but intraoperative implantation of ADM was more effective in reducing the objective incidence of postoperative Frey syndrome than that of parotid submandibular flap, the difference was significant . Conclusions: This study shows that parotid benign tumors can generally prevent the occurrence of postoperative Frey syndrome by parotid cheek flap. For those who can not keep the parotid gingival fascia, simultaneous implantation of ADM can also achieve prophylaxis After the purpose of Frey’s syndrome.