循证医学
循證醫學
순증의학
THE JOURNAL OF EVIDENCE-BASED MEDICINE
2009年
6期
368-372,377
,共6页
张月梅%刘永琦%吴建军%王宏%田曼男%魏志诚%黎小军%拜正刚
張月梅%劉永琦%吳建軍%王宏%田曼男%魏誌誠%黎小軍%拜正剛
장월매%류영기%오건군%왕굉%전만남%위지성%려소군%배정강
翼状胬肉%角膜缘%羊膜%移植%Meta分析
翼狀胬肉%角膜緣%羊膜%移植%Meta分析
익상노육%각막연%양막%이식%Meta분석
pterygium%limbal autograft%amniotic membrane%grafting%meta-analysis
目的 比较角膜缘上皮移植与羊膜移植治疗翼状胬肉的有效性和安全性.方法 计算机检索MEDLINE(1996年至2008年6月)、中国期刊全文数据库(1994年至2008年6月)、中国科技期刊全文数据库(1989年至2008年6月)等数据库.纳入比较自体角膜缘上皮移植和羊膜移植治疗翼状胬肉的随机对照试验,由两名评价者独立检索、评价、提取资料并进行交叉核对.数据统计分析采用Cochrane协作网提供的RevMan 4.2.10软件.结果共纳入41项研究,有41项研究报告了术后翼状胬肉的复发率,共4148只眼;14项研究报告了术后睑球粘连发生率,共1475只眼.Meta分析结果显示,自体角膜缘上皮移植组翼状胬肉复发率为5.03%,羊膜移植组翼状胬肉复发率为10.60%,两组差异有统计学意义(比值比0.45,95%可信区间0.36~0.58,Z=6.42.P<0.000 01);自体角膜缘上皮移植组术后睑球粘连发生率为0.26%,羊膜移植组术后睑球粘连发生率为1.73%,两组差异有统计学意义(比值比0.21,95%可信区间0.07~0.68,Z=2.60,P=0.009).结论 自体角膜缘上皮移植术在预防翼状胬肉复发及术后睑球粘连的发生方面优于羊膜移植术.
目的 比較角膜緣上皮移植與羊膜移植治療翼狀胬肉的有效性和安全性.方法 計算機檢索MEDLINE(1996年至2008年6月)、中國期刊全文數據庫(1994年至2008年6月)、中國科技期刊全文數據庫(1989年至2008年6月)等數據庫.納入比較自體角膜緣上皮移植和羊膜移植治療翼狀胬肉的隨機對照試驗,由兩名評價者獨立檢索、評價、提取資料併進行交扠覈對.數據統計分析採用Cochrane協作網提供的RevMan 4.2.10軟件.結果共納入41項研究,有41項研究報告瞭術後翼狀胬肉的複髮率,共4148隻眼;14項研究報告瞭術後瞼毬粘連髮生率,共1475隻眼.Meta分析結果顯示,自體角膜緣上皮移植組翼狀胬肉複髮率為5.03%,羊膜移植組翼狀胬肉複髮率為10.60%,兩組差異有統計學意義(比值比0.45,95%可信區間0.36~0.58,Z=6.42.P<0.000 01);自體角膜緣上皮移植組術後瞼毬粘連髮生率為0.26%,羊膜移植組術後瞼毬粘連髮生率為1.73%,兩組差異有統計學意義(比值比0.21,95%可信區間0.07~0.68,Z=2.60,P=0.009).結論 自體角膜緣上皮移植術在預防翼狀胬肉複髮及術後瞼毬粘連的髮生方麵優于羊膜移植術.
목적 비교각막연상피이식여양막이식치료익상노육적유효성화안전성.방법 계산궤검색MEDLINE(1996년지2008년6월)、중국기간전문수거고(1994년지2008년6월)、중국과기기간전문수거고(1989년지2008년6월)등수거고.납입비교자체각막연상피이식화양막이식치료익상노육적수궤대조시험,유량명평개자독립검색、평개、제취자료병진행교차핵대.수거통계분석채용Cochrane협작망제공적RevMan 4.2.10연건.결과공납입41항연구,유41항연구보고료술후익상노육적복발솔,공4148지안;14항연구보고료술후검구점련발생솔,공1475지안.Meta분석결과현시,자체각막연상피이식조익상노육복발솔위5.03%,양막이식조익상노육복발솔위10.60%,량조차이유통계학의의(비치비0.45,95%가신구간0.36~0.58,Z=6.42.P<0.000 01);자체각막연상피이식조술후검구점련발생솔위0.26%,양막이식조술후검구점련발생솔위1.73%,량조차이유통계학의의(비치비0.21,95%가신구간0.07~0.68,Z=2.60,P=0.009).결론 자체각막연상피이식술재예방익상노육복발급술후검구점련적발생방면우우양막이식술.
Objective To evaluate the safety and effectiveness of amniotic membrane grafting and limbal autograft in the treatment of pterygium. Methods We searched MEDLINE (1996-2008.6),EMBASE(1974-2008.6),CBMdisc (1996-2008.6) ,CNKI(1990-2008.6)and VIP(1990-2008.6). Only randomized controlled trials(RCTs) were identified. Two reviewers indenpendently searched, assessed the quality of the included trials and then crossed checked the results. We assessed the effect of therapeutic and adverse effect by doing meta-analysis with The Cochrane Collaboration's Review Manager 4.2.10 software. Results 41 RCTs evaluated the pterygium recurrent rate after grafting including 4 148 eyes and the incidence rate including 1 475 eyes. The recurrent rates of pterygium were 5.03% of limbal autograft group, and 10.60% of amniotic membrane grafting group, and the difference was significant between the groups [OR 0.45,95%Cl (0.36,0.58),Z=6.42,P<0.000 01];the incidence of symblepharon was 0.26% of limbal autograft group, and 1.73% of amniotic membrane grafting group, and the difference was significant between the groups too [OR 0.21,95%Cl(0.07,0.68),Z=2.60,P=0.009]. Conclusion Current evidence indicates that limbal autograft is superior to amniotic membrane grafting in reducing the recurrent rate of pterygium and the incidence of symblepharon.