摘要
目的:慢性骨髓炎作为骨科疑难病,治疗过程复杂漫长且极易复发,目前已有研究证实抗生素人工骨治疗慢性骨髓炎效果显著,但仍缺乏循证依据。为此,文章对抗生素人工骨治疗慢性骨髓炎的临床疗效和安全性进行系统评价。方法:检索CNKI、万方、维普、CBM、PubMed和Cochrane Llibrary数据库,检索时间为建库至2020年4月,根据纳入和排除标准,收集有关使用抗生素人工骨治疗慢性骨髓炎的临床对照试验,然后由2名研究人员分别独立对检索到的文献进行筛选、评价和数据提取,质量评价按照Cochrane评价手册和NOS量表进行,最后使用RevMan 5.3软件进行Meta分析。结果:①共纳入13篇临床对照试验,2篇随机临床对照试验质量评价为中等偏倚,11篇回顾性研究评价为高质量文献,共744例患者,治疗组387例,对照组357例;②Meta分析的结果显示:在感染清除率、骨折愈合率、骨折愈合时间、切口愈合时间、治疗有效率、住院时间、再次手术率、并发症发生率、复发率方面,治疗组与对照组相比有显著性差异,治疗组优于对照组(P<0.05)。结论:抗生素人工骨治疗慢性骨髓炎可以提高治疗有效率、缩短治疗时间、更好的控制感染,降低并发症和复发率,该结论还需要未来大样本、更高质量的随机对照试验试验加以验证。
OBJECTIVE:Chronic osteomyelitis is a difficult orthopedic disease.The treatment process is complicated and prolonged.It is easy to relapse.At present,studies have confirmed that antibiotic artificial bone is effective in treating chronic osteomyelitis,but there is still no evidence-based basis.This study systematically evaluated the clinical efficacy and safety of antibiotic artificial bone in the treatment of chronic osteomyelitis.METHODS:The authors searched relevant literature in CNKI,Wanfang,VIP,CBM,PubMed,and Cochrane Llibrary databases.The limit of searching time was from inception to April 2020.Randomized controlled trials on the use of antibiotic artificial bones for chronic osteomyelitis were collected according to the criteria for inclusion and exclusion.Two researchers independently screened,evaluated,and extracted the retrieved documents.The quality evaluation was carried out according to the Cochrane evaluation manual and the NOS scale.The literature data were analyzed using RevMan 5.3 software through a metaanalysis.RESULTS:(1)Two randomized controlled clinical trials evaluated moderately biased quality,and 11 retrospective studies evaluated high-quality literature.A total of 744 patients were included in 13 clinical control trials,including 387 patients in the treatment group and 357 patients in the control group.(2)The results of meta-analysis showed that the treatment group had significant differences from the control group in terms of infection clearance rate,fracture healing rate,fracture healing time,incision healing time,treatment efficiency,length of stay,reoperation rate,complication rate and recurrence rate,and the treatment group was superior to the control group(P<0.05).CONCLUSION:Antibiotic artificial bone treatment of chronic osteomyelitis can improve the treatment efficiency,shorten the treatment time,better control infection,and reduce complications and recurrence rate.This conclusion also needs a larger sample and higher quality randomized controlled trials to verify.
作者
化昊天
赵文宇
张磊
白文博
王新卫
Hua Haotian;Zhao Wenyu;Zhang Lei;Bai Wenbo;Wang Xinwei(Henan University of Chinese Medicine,Zhengzhou 450046,Henan Province,China;Henan Provincial Orthopedic Hospital,Luoyang 471002,Henan Province,China;Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第6期970-976,共7页
Chinese Journal of Tissue Engineering Research
基金
河南省科技攻关项目(182102310487),项目负责人:张磊。
关键词
骨
抗生素
人工骨
万古霉素
素硫酸钙
骨髓炎
感染
骨缺损
META分析
bone
antibiotic
artificial bone
vancomycin
calcium sulfate
osteomyelitis
infection
bone defect
meta-analysis
