目的:评估假肢康复与外科康复在改善上颌骨缺损患者生活质量方面的能力。
方法:对PubMed的系统搜索,Scopus数据库,Cochrane数据库,Ovid数据库,2017年9月之前发表的文章的拉丁美洲和加勒比数据库由两名独立审稿人执行。还对2000年1月至2017年9月发表的文章进行了手动搜索。仅包括评估头颈部癌症患者QoL的英语研究。两位独立审稿人之间的任何混淆都是通过审稿人之间的适度讨论来解决的。
结果:5项研究符合本研究的纳入标准。关于QOL评估的许多参数被用作EORTC头颈部35评估,UW-QOL,OHIP-14,VAS,OFS,MHI,HAD,身体满意度量表,口腔症状检查表,吞咽,饮食组成,疼痛控制,术后并发症,和演讲。两项研究支持与假肢相比改善QOL的手术治疗线;另外两项研究显示,使用手术线的患者QOL改善在统计学上无统计学意义。而只有一个人在两种治疗方式下的QoL差异均不显著。
结论:手术康复为改善上颌骨缺损患者的生活质量提供了更好的治疗方案。另一方面,假肢在手术后立即作为临时策略被证明是有效的,当手术闭塞受损时,它代表了一个很好的选择。
OBJECTIVE: To assess the ability of prosthetic rehabilitation versus surgical rehabilitation in improving the QOL for patients with maxillary defects.
METHODS: A systematic search of PubMed, Scopus data base, Cochrane database, Ovid database, and Latin America & Caribbean database for articles published before September 2017 was performed by two independent reviewers. A manual search of articles published from January 2000 to September 2017 was also conducted. Only English studies were included which evaluate the QoL in patients with head and neck cancers. Any confusion between the two independent reviewers was resolved by means of a moderated discussion between the reviewers.
RESULTS: Five studies fulfilled the inclusion criteria for this study. Many parameters were used regarding evaluation of QOL as the EORTC Head and Neck 35 assessment, UW-QOL, OHIP-14, VAS, OFS, MHI, HAD, Body Satisfaction Scale, Oral symptom check list, Swallowing, Diet consist, Pain control, Postoperative complication, and Speech. Two studies supported the surgical line of treatment for improving the QOL as compared to the prosthetic one; another two studies showed a statistically insignificant improvement in the patients\' QOL with the surgical line, while only one revealed insignificant difference in QoL with both lines of treatment.
CONCLUSIONS: Surgical rehabilitation provides a better line of treatment in improving the QOL for patients with maxillary defects. On the other hand, prosthetic has proved effectiveness in the immediate post-surgical times as temporary strategy, and it has represented a good alternative when the surgical obturation is compromised.