中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
12期
1119-1125
,共7页
张晓南%吴刚%徐瑞泽%白希壮
張曉南%吳剛%徐瑞澤%白希壯
장효남%오강%서서택%백희장
关节成形术,置换,膝%引流术%Meta分析
關節成形術,置換,膝%引流術%Meta分析
관절성형술,치환,슬%인류술%Meta분석
Arthroplasty,replacement,knee%Drainage%Meta-analysis
目的 系统评价进行初次全膝关节置换术后引流与否对疗效的影响,评价两种不同治疗方案的差异,为临床治疗提供参考.方法 检索Cochrane图书馆、PubMed、EMBase、Springer、中国生物医学文献数据库、中国知网、维普和万方数据库,收集筛选初次行人工全膝关节置换术留置引流与否的随机对照试验,采用CONSORT的22条标准进行文献的质量评价,应用RevMan Version 5.1.6软件对数据进行统计分析,采用Cochrane协作网推荐的方法进行meta分析.结果 共纳入21个随机对照试验,纳入的研究不存在发表偏倚.合计1920例患者,其中引流组979例,非引流组941例.引流组在术后软组织瘀斑发生率低于非引流组(OR=0.30,95％ CI:0.24 ～0.49),在术后失血量(MD=320.03,95％CI:235.31 ～404.76)和输血人数(OR=1.83,95％ CI:1.26～ 3.29)上引流组高于非引流组.两组在感染(OR =0.53,95％ CI:0.22～1.32)、深静脉血栓发生率(OR=1.00,95％ CI:0.46 ～2.18)及关节术后活动度(MD=-0.04,95％CI:-1.11 ～ 1.02)等方面差异均无统计学意义.结论 基于当前证据,与不放置引流相比,留置引流并无明显优势.
目的 繫統評價進行初次全膝關節置換術後引流與否對療效的影響,評價兩種不同治療方案的差異,為臨床治療提供參攷.方法 檢索Cochrane圖書館、PubMed、EMBase、Springer、中國生物醫學文獻數據庫、中國知網、維普和萬方數據庫,收集篩選初次行人工全膝關節置換術留置引流與否的隨機對照試驗,採用CONSORT的22條標準進行文獻的質量評價,應用RevMan Version 5.1.6軟件對數據進行統計分析,採用Cochrane協作網推薦的方法進行meta分析.結果 共納入21箇隨機對照試驗,納入的研究不存在髮錶偏倚.閤計1920例患者,其中引流組979例,非引流組941例.引流組在術後軟組織瘀斑髮生率低于非引流組(OR=0.30,95％ CI:0.24 ～0.49),在術後失血量(MD=320.03,95％CI:235.31 ～404.76)和輸血人數(OR=1.83,95％ CI:1.26～ 3.29)上引流組高于非引流組.兩組在感染(OR =0.53,95％ CI:0.22～1.32)、深靜脈血栓髮生率(OR=1.00,95％ CI:0.46 ～2.18)及關節術後活動度(MD=-0.04,95％CI:-1.11 ～ 1.02)等方麵差異均無統計學意義.結論 基于噹前證據,與不放置引流相比,留置引流併無明顯優勢.
목적 계통평개진행초차전슬관절치환술후인류여부대료효적영향,평개량충불동치료방안적차이,위림상치료제공삼고.방법 검색Cochrane도서관、PubMed、EMBase、Springer、중국생물의학문헌수거고、중국지망、유보화만방수거고,수집사선초차행인공전슬관절치환술류치인류여부적수궤대조시험,채용CONSORT적22조표준진행문헌적질량평개,응용RevMan Version 5.1.6연건대수거진행통계분석,채용Cochrane협작망추천적방법진행meta분석.결과 공납입21개수궤대조시험,납입적연구불존재발표편의.합계1920례환자,기중인류조979례,비인류조941례.인류조재술후연조직어반발생솔저우비인류조(OR=0.30,95％ CI:0.24 ～0.49),재술후실혈량(MD=320.03,95％CI:235.31 ～404.76)화수혈인수(OR=1.83,95％ CI:1.26～ 3.29)상인류조고우비인류조.량조재감염(OR =0.53,95％ CI:0.22～1.32)、심정맥혈전발생솔(OR=1.00,95％ CI:0.46 ～2.18)급관절술후활동도(MD=-0.04,95％CI:-1.11 ～ 1.02)등방면차이균무통계학의의.결론 기우당전증거,여불방치인류상비,류치인류병무명현우세.
Objectives To investigate the different effects of closed suction drainage and nondrainage for total knee arthroplasty (TKA) and to provide reference information for the choice of clinical treatment.Methods Randomized controlled trials (RCTs) of closed suction drainage versus non-drainage for TKA were collected from the Cochrane Library,PubMed,EMBase,Springer,CBM,CNKI,VIP and WANFANG database.Methodological quality of the RCTs was independently assessed using the Consolidated Standards of Reporting Trials (CONSORT) checklist.Data analysis was performed by RevMan Version 5.1.6 based on the methods recommended by the Cochrane Collaboration.Results Twenty-one RCTs without bias were finally enrolled,and 1920 enrolled knees were identified into drainage group (979 knees)and non-drainage group (941 knees).A lower incidence of soft tissue ecchymosis was demonstrated in the closed suction drainage group (OR =0.30,95％ CI:0.24-0.49) ; however,compared with the non-drainage group,more loss of blood (MD =320.03,95％ CI:235.31-404.76) and more need of homologous blood transfusion (OR =1.83,95％ CI:1.26-3.29) were found in the closed suction drainage group.In addition,there were no significant differences of postoperative infection (OR =0.53,95％ CI:O.22-1.32),deep venous thrombosis (OR =1.00,95％ CI:0.46-2.18),and the joint range of motion (MD =-0.04,95％ CI:-1.11-1.02) between the two groups.Conclusion Based on the current evidence,no obvious advantage is demonstrated for closed suction drainage,in comparison with non-drainage for TKA.
