上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

不同正颌术式对骨性Ⅲ类错患者上气道影响的meta分析

何金龙， 王云霁， 胡鸿涛， 廖仟， 张维奕， 范小平   

  1. 重庆医科大学附属口腔医院， 口腔疾病与生物医学重庆市重点实验室， 重庆市高校市级口腔生物医学工程重点实验室， 重庆 401147
  • 出版日期:2016-10-28 发布日期:2016-11-29
  • 通讯作者: 范小平， 电子信箱： fanxp666@163.com。 王云霁， 电子信箱： 328957314@qq.com。
  • 作者简介:何金龙（1989—）， 男， 住院医师， 硕士生； 电子信箱： 82150359@qq.com。
  • 基金资助:

    重庆市基础与前沿研究计划项目(cstc2013jcyjA10010)；重庆市卫生计生委学科研项目（2015MSXM053）

Meta-analysis of the effects of different orthognathic surgeries on the upper airway of patients with skeletal class Ⅲ malocclusion

HE Jin-long, WANG Yun-ji, HU Hong-tao, LIAO Qian, ZHANG Wei-yi, FAN Xiao-ping   

  1. Stomatological Hospital of Chongqing Medical University， Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education， Chongqing 401147, China
  • Online:2016-10-28 Published:2016-11-29
  • Supported by:

    Chongqing Research Program of Basic Research and Frontier Technology， cstc2013jcyjA10010; Science Project of the Health and Family Planning Commission of Chongqing， 2015MSXM053

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摘要：

目的·系统比较上颌骨LefortⅠ型截骨前移结合下颌骨后退术与单纯下颌后退术对骨性Ⅲ类错患者上气道的影响。方法·计算机检索Cochrane Library、EMBASE、PubMed、CNKI、万方等中外文数据库中所有比较单纯下颌骨后退术与上颌骨LefortⅠ型截骨前移结合下颌骨后退术对骨性Ⅲ类错患者上气道影响的文献，包括随机对照试验和非随机对照试验，检索日期止于2016年2月29日。对纳入的研究进行质量评价，采用Rev Man 5.3软件对数据进行meta分析。结果·最终纳入6篇病例对照试验文献，共205例患者。meta分析结果显示:在2种术式对气道横截面积(CSA)的影响方面,鼻咽平面（后鼻棘平面）、会厌平面气道CSA改变的差异有统计学意义（P<0.05），软腭平面气道CSA改变的差异无统计学意义；在2种术式对气道容积的影响方面，鼻咽气道容积和上气道总容积改变的差异有统计学意义（P<0.05），口咽气道和喉咽气道容积的变化无统计学意义。结论·与单纯下颌骨后退术比较，上颌骨LefortⅠ型截骨前移术结合下颌骨后退术对骨性Ⅲ类错患者鼻咽、喉咽平面的横截面积及鼻咽气道、上气道总容积的影响更小；对于骨性Ⅲ类错患者，尤其有潜在呼吸问题的患者，上颌骨LefortⅠ型截骨前移结合下颌骨后退术的治疗更佳。

关键词: 下颌骨后退术, 上颌骨LefortⅠ型截骨前移术, 骨性Ⅲ类错, 上气道, meta分析

Abstract:

Objective·To systematically compare the effects of maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery and simple mandibular setback surgery on the upper airway of patients with skeletal class III malocclusion. Methods·Randomized controlled trials and clinical case-control trials about the comparison of effects of maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery and simple mandibular setback surgery on the upper airway of patients with skeletal class Ⅲ malocclusion were retrieved from Cochrane Library, EMBASE, PubMed, CNKI and Wanfang databases up to February 29, 2016. Included studies were evaluated and analyzed using Rev Man 5.3 software. Results·A total of 6 clinical case-control trial articles and 205 cases were included. The results of meta-analysis showed that the difference in cross-sectional area (CSA) changes on the posterior nasal spine plane and epiglottis plane between two procedures was statistically significant (P<0.05), but the difference in CSA changes on the velar plane was not statistically significant. The difference in nasopharynx volume and upper airway volume changes was statistically significant (P<0.05), but the difference in oropharynx volume and hypopharynx volume changes was not statistically significant. Conclusion·Compared with simple mandibular setback surgery, maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery has slighter effects on CSAs on nasopharynx plane and hypopharynx plane and volumes of nasopharynx volume and upper airway. The combined surgery is more suitable for the treatment of patients with skeletal class Ⅲ malocclusion, especially for those with potential breathing problems.

Key words: mandibular setback surgery, maxillary Lefort Ⅰ osteotomy advancement surgery , skeletal class Ⅲ malocclusion, upper airway, meta analysis