CAJ | 학술논문

背景:全髋关节置换后非类固醇类抗炎药常被用来预防异位骨形成,但是其有效性和安全性尚无定论.目的:用荟萃分析的方法定量评价全髋关节置换术后应用非类固醇类抗炎药的有效性和安全性.方法:计算机检索PubMed、EMBASE、Cochrane Library、CBM、CNKI、VIP数据库,追查纳入文献的参考文献,全面搜集有关全髋关节置换后应用非类固醇类抗炎药的随机对照试验,用RevMan5.0软件进行统计分析.结果与结论:共纳入13篇随机对照试验(4 706例患者),Meta分析结果显示:与安慰剂组相比,低剂量的阿司匹林组在预防异位骨形成方面差异无显著性意义[RR=0.99,95%CI(0.87,1.14),而中到高剂量的非类固醇类抗炎药组在预防异位骨形成方面差异有显著性意义[RR=0.44,95%CI(0.30,0.64);在轻度的胃肠道不良反应方面两组差异有显著性意义[RR=2.15,95%CI(1.28,3.61)],在改善髋关节疼痛方面和躯体功能方面差异无显著性意义[MD=-0.1,95%CI(-0.1,0.4)];7 Gy放疗组和非类固醇类抗炎药相比异位骨形成发生率分别为11.1%和16.0%.除低剂量的阿司匹林外,全髋关节置换术后应用中到高剂量非类固醇类抗炎药可显著降低患者异位骨的形成,但非类固醇类抗炎药组轻度的胃肠道反应较高,有限的证据表明非类固醇类抗炎药和安慰剂组在髋关节疼痛缓解和躯体功能改善方面无显著性差异,7 Gy放疗组在降低异位骨形成发生率方面优于非类固醇类抗炎药组.
배경:전관관절치환후비류고순류항염약상피용래예방이위골형성,단시기유효성화안전성상무정론.목적:용회췌분석적방법정량평개전관관절치환술후응용비류고순류항염약적유효성화안전성.방법:계산궤검색PubMed、EMBASE、Cochrane Library、CBM、CNKI、VIP수거고,추사납입문헌적삼고문헌,전면수집유관전관관절치환후응용비류고순류항염약적수궤대조시험,용RevMan5.0연건진행통계분석.결과여결론:공납입13편수궤대조시험(4 706례환자),Meta분석결과현시:여안위제조상비,저제량적아사필림조재예방이위골형성방면차이무현저성의의[RR=0.99,95%CI(0.87,1.14),이중도고제량적비류고순류항염약조재예방이위골형성방면차이유현저성의의[RR=0.44,95%CI(0.30,0.64);재경도적위장도불량반응방면량조차이유현저성의의[RR=2.15,95%CI(1.28,3.61)],재개선관관절동통방면화구체공능방면차이무현저성의의[MD=-0.1,95%CI(-0.1,0.4)];7 Gy방료조화비류고순류항염약상비이위골형성발생솔분별위11.1%화16.0%.제저제량적아사필림외,전관관절치환술후응용중도고제량비류고순류항염약가현저강저환자이위골적형성,단비류고순류항염약조경도적위장도반응교고,유한적증거표명비류고순류항염약화안위제조재관관절동통완해화구체공능개선방면무현저성차이,7 Gy방료조재강저이위골형성발생솔방면우우비류고순류항염약조.
BACKGROUND:The non-steroidal antiinflammatory drugs (NSAIDs) were widely used to prevent heterotopic bone formation following total hip arthroplasty (THA),however,its efficacy and safety is poorly understood.OBJECTIVE:To determine the efficacy and safety of postoperative NSAIDs therapy in patients undergoing THA using Meta analysis.METHODS:The databases of PubMed,Embase,Cochrane Library,Chinese biomedical literature,CNKI,VIP as well as bibliographies of retrieved articles were researched for randomized controlled trials comparing NSAID versus control after THA,and the data were analyzed using Review Manager 5.0.RESULTS AND CONCLUSION:A total of 13 randomized controlled trials totaling 4706 participants were included.The result of meta analysis showed that low dose aspirin did not significantly affect the incidence of heterotopic bone formation (HBF) [RR=0.99,95% CI (0.87,1.14) rather than medium to high dose NSAIDs [RR=0.44,95% CI(0.30,0.64),there was no significant difference between two group in hip pain and physical function,the incidence of HBF was 16.0% in NSAID-group and 11.1% in 7 Gy group.Apart from low dose aspirin,medium to high doses of postoperative NSAIDs produce a substantial reduction in the incidence of HBF at the cost of minor high gastrointestinal side effect.Limited evidence showed there were no significant differences between the groups for improvements in hip pain and physical function,7 Gy fraction is more effective than use of NSAID.