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目的:比较游离皮瓣修复术中应用微血管吻合器（MAD）与手工缝合（HS）的效果和安全性。方法:检索Pubmed、Embase、CNKI、万方、CBM和维普等数据库,收集1950年1月至2019年10月国内外正式刊物上公开发表的有关在游离皮瓣修复软组织缺损中采用MAD与HS对比的研究,严格评价纳入研究的文献质量及提取相关资料,运用RevMan 5.3软件统计分析所有相关数据。结果:共纳入15项研究,包含5 539例患者。资料分析显示,与HS组相比,MAD组静脉吻合时间明显较短（n SMD=-5.46, 95% n CI: -7.50, -3.41, n P<0.001）,动脉吻合时间较短（n SMD=-5.16, 95% n CI: -9.61, -0.71, n P=0.02）,血管危象出现率较低（n RR=0.49, 95% n CI: 0.34, 0.70, n P<0.001）,皮瓣坏死率较低（n RR=0.52, 95% n CI: 0.32, 0.86, n P=0.01）,两组间差异均有统计学意义（n P<0.05）。n 结论:对于游离皮瓣修复软组织缺损,应用MAD与HS相比,在动脉和静脉吻合时间、血管危象以及皮瓣坏死率方面可能有优势。“,”Objective:To compare the efficacy and safety between microvascular anastomostive device (MAD) and hand-sewn (HS) in free flap reconstruction.Methods:Databases in Pubmed, Embase, CNKI, Wanfang, CBM and Weipu etc. The comparative study of MAD device and manual suture in free flap repair of soft tissue defects published in domestic and foreign official journals from January, 1950 to October, 2019 was collected. The quality of the included studies was strictly evaluated and relevant data were extracted. Revman 5.3 software was used to analyze all relevant data.Results:Fifteen trials with 5 539 patients were included. There was significant difference between MAD and HS in time of venous anastomoses (n SMD=-5.46, 95% n CI: -7.50, -3.41, n P<0.001), time of artery anastomoses (n SMD=-5.16, 95% n CI: -9.61, -0.71, n P=0.02), vascular crisis (n RR=0.49, 95% n CI: 0.34, 0.70, n P<0.001) and flap necrosis (n RR=0.52, 95% n CI: 0.32, 0.86, n P=0.01), the difference between the 2 groups was statistically significant (n P< 0.05).n Conclusion:According to the analyses of the pooled results of MAD group and HS group, the data tend to suggest that MAD is superior to HS in the reconstruction with free flap.