摘要
目的应用Meta分析的方法系统评价骨水泥型与生物型人工半髋关节置换治疗老年粗隆间骨折的近期临床疗效。方法计算机检索Cochrane Library,MEDLINE,PubMed,Ovid,EMBASE,CBM,CNKI,Articles,VIP等数据库从建库至2018年1月的相关文献,手工检索中华系列及骨科类杂志近5年的相关文献,筛选出关于骨水泥型与生物型半髋关节置治疗换老年粗隆间骨折的随机对照试验文献(RCTs),严格评价纳入研究的方法学质量,采用Cochrane协作网提供的Rev Man 5. 3进行统计学分析。结果最后共纳入17篇符合要求的文章,共1 233例患者,Meta分析结果显示,与骨水泥组相比,生物型组手术时间短[MD=8. 20,95%CI(7. 09,9. 03),P <0. 01],死亡率低[OR=2. 45,95%CI(1. 11,5. 41),P=0. 03],但术后出血量多[MD=-13. 23,95%CI(-20. 70,-5. 76),P=0. 0005],在术中出血量、术后下地时间、术后6个月及12个月髋关节功能Harris评分、术后假体并发症、心脑血管并发症、感染及深静脉血栓发生率两组之间差异无统计学意义(P>0. 05)。结论对于半髋关节置换治疗老年粗隆间骨折的近期临床疗效,生物型假体在手术时间、死亡率等方面优于骨水泥型假体,但术后出血量较多。
Objective To evaluate the efficacy of cemented and non-cemented hemiarthroplasty for intertrochanteric fracture in the elderly patients using meta-analysis.Methods Related randomized controlled trials about cemented and non-cemented hemiarthroplasty for intertrochanteric fracture in the elderly patientsliterature were collected by computerized search of online database including Cochrane Library,MEDLINE,PubMed,Ovid,EMBASE,CBM,CNKI,Articles,VIP and other database;the search period was set as from establish of the database to January 2018,and by manual search of Chinese Medical Journal and other orthopedics journals in the last five years.The quality of trials was strictly assessed.RevMan 5.3 software provided by the Cochrane Collabiration was used for data analysis.Results Seventeen RCTs involving 1 233 patients were finally enrolled.According to the meta-analysis,compared with the cement group,the non-cement group had shorter operation time[MD=8.20,95%CI(7.09,9.03),P<0.01],lower mortality[OR=2.45,95%CI(1.11,5.41),P=0.03],but more blood loss after operation[MD=-13.23,95%CI(-20.70,-5.76),P=0.0005],and there was no significant difference in the bleeding volume,ambulation time,Harris score of hip function at six months and 12 months,prosthetic complication,cardiovascular complication,infection and deep venous thrombosis between the two surgical methods(P>0.05).Conlusion For intertrochanteric fracture in the elderly patients,the non-cemented hemiarthroplasty is superior to cemented hemiarthroplasty in terms of operation time and mortality,but more postoperative bleeding.
作者
巩栋
赵婧
刘军
邓银栓
甄平
Gong Dong;Zhao Jing;Liu Jun;Deng Yinshuan;Zhen Ping(Department of Orthopedics,Lanzhou General Hospital of Lanzhou Military Command,Lanzhou 730050,China;Gansu University of Chinese Medicine,Lanzhou 730000,China)
出处
《中华关节外科杂志（电子版）》
CAS
2018年第6期777-785,共9页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
全军后勤科研计划面上项目(CWH17J007
CWH17J009)
甘肃省自然科学基金项目(1606RJZA208
18JR3RA409)
