比较游离皮瓣修复头颈部重建术后患者上肢残疾的报告：系统评价和荟萃分析。
Comparison of patient-reported upper extremity disability following free flaps in head and neck reconstruction: A systematic review and meta-analysis.
机构信息
Department of Otolaryngology-Head & Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Howe Library, Mass Eye and Ear, Boston, Massachusetts, USA.
出版信息
Head Neck. 2023 Jul;45(7):1832-1840. doi: 10.1002/hed.27375. Epub 2023 May 2.
BACKGROUND
Comparisons of patient-reported donor site morbidity based on the Disabilities in Arm, Shoulder, and Hand (DASH) instrument across upper trunk free flaps in head and neck surgery, including radial forearm (RFFF), osteocutaneous radial forearm (OCRFF), scapular tip (STFF), and serratus anterior (SAFF) free flaps, may help inform donor tissue selection.
METHODS
In this meta-analysis, 12 studies were included and the primary outcome was average DASH score.
RESULTS
The pooled DASH scores were 12.14 (95% CI: 7.40-16.88) for RFFF (5 studies), 17.99 (11.87-24.12) for OCRFF (2 studies), 12.19 (8.74-15.64) for STFF (3 studies), and 16.49 (5.92-27.05) for SAFF (2 studies) and were not significantly different.
CONCLUSIONS
Results suggest that patients generally function well, with minimal to mild donor site morbidity, when assessed at an average of 20 months after flap harvest. These results are based on few effects from primarily retrospective studies of fair quality, and further research is needed.
背景
对头颈部手术中使用的上干游离皮瓣（包括桡侧前臂游离皮瓣[RFFF]、骨皮结合桡侧前臂游离皮瓣[OCRFF]、肩胛冈皮瓣[STFF]和前锯肌游离皮瓣[SAFF]），基于手臂、肩部和手部残疾（DASH）量表对患者报告的供区发病率进行比较，可能有助于选择供区组织。
方法
本荟萃分析纳入了 12 项研究，主要结局指标为平均 DASH 评分。
结果
RFFF（5 项研究）的汇总 DASH 评分为 12.14（95%CI：7.40-16.88），OCRFF（2 项研究）为 17.99（11.87-24.12），STFF（3 项研究）为 12.19（8.74-15.64），SAFF（2 项研究）为 16.49（5.92-27.05），差异无统计学意义。
结论
这些结果表明，在皮瓣采集后平均 20 个月进行评估时，患者的功能通常良好，供区发病率低至轻度。这些结果基于少数质量一般的主要为回顾性研究的影响，还需要进一步研究。
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