摘要
目的系统评价特发性黄斑裂孔(idiopathic macular hole,IMH)术后颜面向下体位与非面向下体位对黄斑裂孔闭合率的影响。方法通过搜索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science等数据库,查找关于颜面向下体位与非面向下体位对特发性黄斑裂孔闭合率影响的随机对照试验(randomized controlled trial,RCT)。本研究共纳入6篇RCT,研究对象共计478例,其中颜面向下体位249例(大裂孔111例,小裂孔138例),非面向下体位229例(大裂孔100例,小裂孔129例),对纳入的数据应用RevMan5.4进行分析,主要指标包括黄斑裂孔总体闭合率和基于黄斑裂孔大小的亚组分析。结果颜面向下体位组的总体黄斑裂孔闭合率显著高于非面向下体位组(OR=0.23,95%CI:0.10~0.52,P<0.001),小裂孔闭合率两组间比较差异无统计学意义(OR=0.46,95%CI:0.11~1.93,P=0.290),大裂孔闭合率两组间比较差异有统计学意义(OR=0.18,95%CI:0.07~0.47,P<0.001)。结论黄斑裂孔>400μm的患者,采用颜面向下体位可提高裂孔闭合率。直径≤400μm的小裂孔患者,非面向下体位组裂孔闭合率良好,术后需避免仰卧位,无需强制术后面部朝下体位。
Objective:To assess the effect of face-down position and non-face-down posturing on the closure rate of idiopathic macular hole after surgery.Methods:Chinese and English database,such as CNKI,Wanfang,VIP,China Biomedical Literature Database,PubMed,Embase,Web of Science and other databases were searched using computer about randomized controlled trial(RCT)on the effect of the macular hole closure rate with or without face-down position.A total of 6 RCTs(478 patients)were included in this meta-analysis,including 249 eyes of face-down position group(111 eyes of large hole,138 eyes of small hole),229 eyes in the non-face-downposturing group(100 eyes of large holes,129 eyes of small holes).RevMan5.4 software was used to analyze the included data.The main indicators included the overall closure rate of macular holes and subgroup analysis based on the size of macular holes.Results:Meta-analysis indicated that there was statistical significance on the overall macular hole closure rate between the face-down position group and the non-facedown posturing group(OR=0.23,95%CI:0.10-0.52,P<0.001).There was no statistically significant difference between the two groups in the small fissure closure rate(OR=0.46,95%CI:0.11-1.93,P=0.290).There was a statistically significant difference in the closure rate of major fissure between the two groups(OR=0.18,95%CI:0.07-0.47,P<0.001).Conclusion:Face-down position can improve the closure rate of the hole for holes lager than 400μm.The non-face-down is equally effective for face-down position in the repair of small macular holes less than 400μm.As long as the supine position is avoided,the face-down position is not always necessary.
作者
刘翠红
胡兵
宋洁
刘欣
徐真真
季红
LIU Cuihong;HU Bing;SONG Jie;LIU Xin;XU Zhenzhen;JI Hong(Nursing School of Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250002,China;Department of Nursing,The First Affiliated Hospital of Shandong First Medical University,Jinan 250014,China)
出处
《山东第一医科大学（山东省医学科学院）学报》
CAS
2023年第1期36-41,共6页
Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences
基金
山东省人文社会科学课题(2022-ZXJK-04)
山东省中医药科技项目(2020Q022)。
