中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (2): 171-176.doi: 10.19438/j.cjoms.2020.02.017

• 循证医学 • 上一篇    下一篇

早期系统化康复训练在口腔癌术后游离皮瓣修复患者中应用效果的meta分析

叶海春1, 高先连1, 任阳2, 李丽1   

  1. 1.南京大学医学院附属口腔医院,南京市口腔医院 口腔颌面外科;
    2.牙周病科,江苏 南京 210008
  • 收稿日期:2019-04-11 修回日期:2019-09-30 出版日期:2020-03-20 发布日期:2020-04-30
  • 通讯作者: 李丽,E-mail:1801971012@qq.com
  • 作者简介:叶海春（1990-）,女,在读硕士研究生,E-mail:695591465@qq.com
  • 基金资助:
    南京市卫生科技发展项目（YKK18125）

Effect of early rehabilitation training in patients with oral cancer after free flap reconstruction: a meta-analysis

YE Hai-chun1, GAO Xian-lian1, REN Yang2, LI Li1   

  1. 1.Department of Oral and Maxillofacial Surgery;
    2.Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University. Nanjing 210008, Jiangsu Province, China
  • Received:2019-04-11 Revised:2019-09-30 Online:2020-03-20 Published:2020-04-30

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摘要： 目的:系统评价早期系统化康复训练在口腔癌根治伴游离皮瓣修复术后患者中的应用效果。方法:计算机检索Cochrane Library、Web of Science、PubMed、Embase等英文数据库以及中国知网、维普和万方等中文数据库,获取国内外关于早期系统化康复训练在口腔癌根治术后患者中应用的随机对照试验。由2名研究者按照纳入和排除标准筛选文献并提取资料,参考Cochrane Handbook 5.1质量评价标准进行文献质量评价,使用Review Manager 5.3软件进行meta分析。结果:共纳入12篇符合标准的文献,meta分析结果显示,试验组术后2周洼田饮水试验评分显著低于对照组[SMD=-1.22,95%CI（-1.55,-0.90）,Z=7.41,P<0.001],试验组术后语言清晰度有效率显著优于对照组[RR=1.44,95%CI（1.16,1.78）,Z=3.33,P<0.001],试验组术后3个月、6个月语音清晰度评分显著高于对照组,差异均有统计学意义[MD=13.01,95%CI（6.78,19.24）,Z=4.09,P<0.001;MD=7.90,95%CI（3.19,12.61）,Z=3.29,P<0.01]。结论:早期系统化康复训练有助于口腔癌切除伴游离皮瓣修复术后患者吞咽功能和语音功能的恢复。

关键词: 口腔癌, 康复, 功能训练, 吞咽功能, 语音清晰度, Meta分析

Abstract: PURPOSE： To evaluate the effect of early systematic rehabilitation training on oral cancer patients after radical resection with free flap to repair soft tissue defects. METHODS: Randomized controlled trials (RCTs) on the effects of early rehabilitation training on function recovery of patients with oral cancer in China and aboard were retrieved from the Cochrane Library, Web of Science, PubMed, Embase, China National Knowledge Infrastructure, VIP Citation Database, and WanFang Data. Review Manager 5.3 software was used to perform meta analysis. RESULTS: A total of 12 eligible literatures were included. Meta analysis showed that the swallowing function score in the experimental group was significantly lower than that of the control group 2 weeks after surgery[SMD=-1.22, 95%CI(-1.55,-0.90), Z=7.41, P<0.001]. The excellent and good rate of speech intelligibility of the patients in the experimental group was significantly higher than that in the control group [RR=1.44, 95%CI(1.16,1.78), Z=3.33, P<0.001]. The speech intelligibility score in the experimental group was significantly higher than those in the control group 3 and 6 months after surgery[MD=13.01, 95%CI(6.78,19.24), Z=4.09, P<0.001;MD=7.90, 95%CI(3.19,12.61), Z=3.29, P<0.01]. CONCLUSIONS: Early rehabilitation training is helpful to recovery of swallowing function and speech function in patients with oral cancer after free flap repair.

Key words: Oral cancer, Rehabilitation, Function training, Swallowing function, Speech intelligibility, Meta analysis

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