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目的系统评价聚左旋丙交酯(poly-L-lactide,PLLA)材料相对于传统钛板治疗下颌骨骨折的效果。方法计算机检索Cochrane图书馆、Pub Med、Embase、中国期刊全文数据库、维普数据库、万方数据库等,检索时间为2007年1月—2017年3月,查找使用PLLA材料治疗下颌骨骨折的随机或非随机对照试验,试验组使用PLLA材料(PLLA组),对照组使用钛板(钛板组)。由2名评价者独立进行文献质量评价和资料提取后采用Review Manager 5.3软件进行分析。结果共纳入8篇文献,共453例下颌骨骨折患者。PLLA组和钛板组术后总体发生并发症的例数均为27例,差异无统计学意义[比值比(odds ratio,OR)=0.98,95%置信区间(confidence interval,CI)(0.55,1.75),P=0.95]。对每种并发症进行单独分析,两组错位愈合[OR=0.96,95%CI(0.46,2.01),P=0.90]、咬合紊乱[OR=1.53,95%CI(0.61,3.87),P=0.37]、感染[OR=0.63,95%CI(0.23,1.74),P=0.37]、二次手术[OR=0.46,95%CI(0.17,1.27),P=0.14]差异均无统计学意义。结论 PLLA材料与传统钛板在下颌骨骨折的治疗效果无明显差异。
Objective To evaluate the effect of poly-L-lactide (PLLA) on the treatment of mandibular fractures in comparison with traditional titanium plates. METHODS: The Cochrane Library, Pub Med, Embase, Chinese Journal Full-text Database, VIP database, Wanfang database were searched by computer. The data were searched from January 2007 to March 2017 to find out whether random or not Randomized controlled trials, PLLA group (PLLA group) and titanium group (titanium group) were used as control group. Two reviewers conducted independent literature review and data extraction and analyzed them using Review Manager 5.3 software. Results A total of 8 articles were included, 453 patients with mandibular fracture. The overall incidence of postoperative complication in both PLLA and titanium plate groups was 27, with no significant difference (odds ratio, OR = 0.98, 95% confidence interval (CI), 0.55, 1.75), P = 0.95]. The complications of each complication were analyzed separately (OR = 0.96, 95% CI 0.46, 2.01, P 0.90), occlusion disorder (OR 1.53, 95% CI 0.61, 3.87), P = 0.37], infection [OR = 0.63,95% CI (0.23,1.74), P = 0.37], and there was no significant difference in the second surgery [OR = 0.46,95% CI (0.17,1.27), P = 0.14] . Conclusion There is no significant difference between the PLLA and traditional titanium in the treatment of mandibular fractures.