CAJ | 학술논문

目的应用Meta分析的方法，对单纯松解术（simple decompression，SD）与神经前置术（anteri-or transposition，AT）治疗肘管综合征的疗效差异进行评价，为临床选择适当术式提供依据。方法计算机检索Pubmed、EMBASE、Ovid、Cochrane图书馆和ClinicalTrials．gov网站数据库，检索相关的随机对照试验和回顾性对照研究，利用RevMan 5.0软件进行异质性分析及Meta分析，绘制森林图。结果本文检索了1980～2012年间发表的591篇相关文献，经过筛选和评价，最后纳入9篇（共685例患者）随机对照试验和质量较高的回顾性对照研究，Meta分析显示SD和AT对术后肌电图运动神经传导速度[SMD＝1.46，95％CI（-0.95，3.87），P＝0.23]和术后优良率[RR＝0.96，95％CI（-0.88，1.05），P＝0.39]的影响没有差异，SD能降低术后并发症[RR＝0.39，95％CI（0.22，0.68），P＜0.01]，两种疗法对中度以上肘管综合征患者术后评分的影响亦无差异[RR＝1.09，95％CI（0.90，1.31），P＝0.38]。结论对于单纯的肘管综合征，SD能降低术后并发症，是较AT更值得推荐的手术方法。
목적응용Meta분석적방법，대단순송해술（simple decompression，SD）여신경전치술（anteri-or transposition，AT）치료주관종합정적료효차이진행평개，위림상선택괄당술식제공의거。방법계산궤검색Pubmed、EMBASE、Ovid、Cochrane도서관화ClinicalTrials．gov망참수거고，검색상관적수궤대조시험화회고성대조연구，이용RevMan 5.0연건진행이질성분석급Meta분석，회제삼림도。결과본문검색료1980～2012년간발표적591편상관문헌，경과사선화평개，최후납입9편（공685례환자）수궤대조시험화질량교고적회고성대조연구，Meta분석현시SD화AT대술후기전도운동신경전도속도[SMD＝1.46，95％CI（-0.95，3.87），P＝0.23]화술후우량솔[RR＝0.96，95％CI（-0.88，1.05），P＝0.39]적영향몰유차이，SD능강저술후병발증[RR＝0.39，95％CI（0.22，0.68），P＜0.01]，량충요법대중도이상주관종합정환자술후평분적영향역무차이[RR＝1.09，95％CI（0.90，1.31），P＝0.38]。결론대우단순적주관종합정，SD능강저술후병발증，시교AT경치득추천적수술방법。
Objective To evaluate the efficacy of simple decompression ( SD) versus anterior transposition ( AT) of the ulnar nerve in the treatment of cubital tunnel syndrome ( CTS) ,and provide the basis for clinical selection of proper operation method .Methods PubMed,EMBASE,Ovid,the Cochrane Central Register of Controlled Trials and database of Clinical Trials .gov were searched for randomized controlled studies and comparative studies comparing the effect of SD and AT of the ulnar nerve in CTS from January 1980 to January 2012 .Included studies were assessed for quality and heterogeneity .RevMan 5.0 software was used for data analysis .Results 591 studies were retrieved for this paper .After screening and evaluation ,nine studies involving 685 cases were identified in this analysis.There were no statistically significant difference between SD and AT in terms of the improvement of clinical scores[RR=0.96,95%CI( -0.88,1.05),P =0.39],postoperative motor nerve-conduction velocities [SMD =1.46,95%CI (-0.95,3.87),P=0.23],and the improvement of clinical scores of medium and high-grade cases in CTS[RR=1.09,95%CI(0.90,1.31),P=0.38].This Meta-analysis showed that compared with AT,SD could reduce the rate of complication[RR=0.39,95%CI(0.22,0.68),P<0.01].Conclusions This report suggest that SD of the ulnar nerve is a reasonable alternative to AT for the surgical treatment of CTS .