摘要
目的:通过Meta分析探讨髋关节置换术后假体脱位发生的主要危险因素,为髋关节置换术后假体脱位的治疗与护理提供依据。方法:系统收集中国知网、万方数据库、EMbase、MedLine、PubMed、CINAHL、the Cochrane Library、澳大利亚Joanna Briggs Institute循证卫生保健中心从建库至2021年9月20日有关髋关节置换术后假体脱位危险因素的研究。对符合标准的文献采用RevMan 5.3软件进行Meta分析。结果:最终纳入14篇符合要求的横断面研究文献,总样本量6 989例。Meta分析显示,女性[OR=2.30,95%CI(1.55,3.42)]、既往手术史[OR=3.67,95%CI(2.67,5.04)]、合并精神或肢体疾病[OR=12.27,95%CI(7.22,20.58)]、年龄>75岁[OR=3.72,95%CI(2.26,6.13)]、假体放置安全区外[OR=2.34,95%CI(1.53,3.58)]、人工股骨头直径<30 mm[OR=3.95,95%CI(2.22,7.03)]、手术入路为后外侧[OR=4.73,95%CI(3.22,6.95)]、体位控制不当[OR=2.11,95%CI(1.46,3.05)]、搬运不当[OR=13.75,95%CI(9.93,19.03)]是髋关节置换病人术后发生假体脱位的危险因素。结论:现有证据表明,髋关节置换术后假体脱位的发生与多种因素有关,其中女性、既往手术史、合并精神或肢体疾病、年龄>75岁、假体放置安全区外、人工股骨头直径<30 mm、手术入路为后外侧、体位控制不当、搬运不当可增加髋关节置换术后假体脱位的发生风险。
Objective:To explore the main risk factors for postoperative dislocation of hip arthroplasty,and to provide reference for the treatment and nursing of postoperative dislocation of hip arthroplasty by Meta-analysis.Methods:A systematic collection of research on the risk factors of hip replacement dislocation was conducted from the establishment of the database by CNKI,WanFang Database,EMbase,MedLine,PubMed,CINAHL,the Cochrane Library,and Joanna Briggs Institute.The retrieval time was from inception to september 20,2021.Meta-analysis was conducted on literature that met the standards using RevMan 5.3 software.Results:14 cross-sectional studies that met the requirements were ultimately included,with a total sample size of 6989 cases.Meta-analysis showed that females(OR=2.30,95%CI 1.55-3.42),previous surgical history(OR=3.67,95%CI 2.67-5.04),comorbidities with mental or limb diseases(OR=12.27,95%CI 7.22-20.58),age>75 years old(OR=3.72,95%CI 2.26-6.13),prosthesis placement outside the safety zone(OR=2.34,95%CI 1.53-3.58),artificial femoral head diameter<30 mm(OR=3.95,95%CI 2.22-7.03),posterolateral in surgical approach(OR=4.73,95%CI 3.22-6.95),improper posture control(OR=2.11,95%CI 1.46-3.05)and improper handling(OR=13.75,95%CI 9.93-19.03)were risk factors for postoperative dislocation of hip arthroplasty patients.Conclusion:Current evidence suggests that the occurrence of prosthetic dislocation after hip arthroplasty is related to multiple factors,including female gender,previous surgical history,comorbidities with mental or limb diseases,age>75 years old,placement outside the safe zone,diameter of the artificial femoral head<30 mm,posterior lateral surgical approach,improper posture control,and improper handling,which can increase the risk of prosthetic dislocation after hip arthroplasty.
作者
苏印
刘洪娟
王兰
吴明珑
黄媛
潘美琪
SU Yin;LIU Hongjuan;WANG Lan;WU Minglong;HUANG Yuan;PAN Meiqi(Tongji Hospital,Tongji Medical College of HUST,Hubei 430030 China)
出处
《循证护理》
2023年第20期3663-3669,共7页
Chinese Evidence-Based Nursing
基金
2021年华中科技大学同济医学院附属同济医院专项科研基金项目,编号:2021D19。
关键词
髋关节置换术
假体脱位
危险因素
META分析
循证护理
hip joint replacement surgery
prosthesis dislocation
risk factors
Meta-analysis
evidence-based nursing
