Xuanwu Hospital of Capital Medical University
目的：系统评价应用鼻中隔黏膜瓣重建鼻咽部放疗后坏死（PRNN）清创术后鼻咽部缺损的有效性。方法：应用计算机检索Pubmed、Cochrane Library、Embase、Web of Science等英文数据库，以及中国知网（CNKI）、万方（WANFANG）、维普(VIP)等中文数据库，检索时间为自数据库建立至2021年2月1日，检索鼻中隔黏膜瓣修复PRNN术后鼻咽部缺损的临床研究。由两位研究者独立筛选文献、提取资料后，应用RStuido软件进行效应量分析。结局指标为鼻中隔黏膜瓣重建鼻咽部缺损的有效率。此外，搜索并分析仅以鼻咽坏死组织清创治疗PRNN的研究作为参考。结果：初次检索获得文献1005篇，根据纳入及排除标准，最终纳入5篇单臂回顾性研究，共145例患者，鼻中隔黏膜瓣重建鼻咽部缺损成功率为84%（95%CI=[0.72,0.96]，I2=74%）。同时，检索到9篇仅以鼻咽坏死组织清创治疗PRNN的研究，其上皮化率为47%（95%CI=[0.31,0.62]，I2=94%）结论：鼻中隔黏膜瓣作为有效的修补材料，可用于PRNN清创手术中鼻咽部缺损的重建，需要更多的前瞻性队列研究或随机对照试验以进一步研究。
Objective: To systematically evaluate the effectiveness of nasal septum mucosal flap for postopertive reconstruction of Postradiation nasopharyngeal necrosis (PRNN). METHODS: English databases, such as PubMed, Cochrane Library, Embase, Web of Science, and Chinese databases, such as CNKI, Wanfang, VIP were searched by computer. The retrieval time was from the establishment of the database to February 1, 2021. To search the clinical studies of repairing nasopharynx defect after operation of PRNN with nasal septum mucosal flap. Two researchers independently screened the literatures and extracted the data, then the analysis was carried out using the software Rstudio. The outcome index was the effectiveness of nasal septum mucosal flap in repairing nasopharyngeal defect. In addition, we searched and analyzed studies of PRNN treated by debridement of nasopharyngeal necrotic tissue as a reference. RESULTS: A total of 1005 literatures were retrieved initially. According to the inclusion and exclusion criteria, 5 single-arm studies were included, including 145 patients. The success rate of reconstruction of nasopharyngeal defects by nasal septum mucosal flap was 84% （95%CI=[0.72,0.96]，I2=74%）. At the same time, we searched for 9 studies of PRNN treated by debridement of nasopharyngeal necrotic tissue, with an epithelization rate of 47%47%（95%CI=[0.31,0.62]，I2=94%）. Conclusion: Nasal septum mucosal flap can be used as an effective repair material to reconstruct defects after debridement of PRNN. More prospective cohort studies or randomized controlled trials are needed for further study.