CAJ | 학술논문

目的：通过 meta 分析评价股骨近端防旋髓内钉(PFNA)与动力髋螺钉(DHS)固定治疗成人股骨粗隆间骨折的疗效差异。方法收集比较 PFNA 和 DHS 治疗成人股骨粗隆间骨折临床疗效的中、英文随机对照研究,评价纳入研究的方法学质量并提取资料。结果共纳入9篇文献,其中 PFNA 固定392例,DHS 固定398例。 PFNA 固定与 DHS 固定相比,平均手术时间缩短,术中失血量减少,手术切口长度较短,术后并发症总发生率降低(P <0.05)；而在平均住院日、髋关节功能 Harris 评分优良率方面二者尚无显著的统计学差异(P >0.05)。结论与 DHS 相比,采用 PFNA 固定治疗成人股骨粗隆间骨折具有手术时间短、出血量少、手术创伤小、术后并发症发生率低等优点,但尚无足够的证据表明二者在平均住院日及髋关节功能 Harris 评分优良率方面有差异。
목적：통과 meta 분석평개고골근단방선수내정(PFNA)여동력관라정(DHS)고정치료성인고골조륭간골절적료효차이。방법수집비교 PFNA 화 DHS 치료성인고골조륭간골절림상료효적중、영문수궤대조연구,평개납입연구적방법학질량병제취자료。결과공납입9편문헌,기중 PFNA 고정392례,DHS 고정398례。 PFNA 고정여 DHS 고정상비,평균수술시간축단,술중실혈량감소,수술절구장도교단,술후병발증총발생솔강저(P <0.05)；이재평균주원일、관관절공능 Harris 평분우량솔방면이자상무현저적통계학차이(P >0.05)。결론여 DHS 상비,채용 PFNA 고정치료성인고골조륭간골절구유수술시간단、출혈량소、수술창상소、술후병발증발생솔저등우점,단상무족구적증거표명이자재평균주원일급관관절공능 Harris 평분우량솔방면유차이。
Objective To evaluate the difference in efficacy between proximal femoral nail antirotation ( PFNA) and dynamic hip screw (DHS) in treatment of adults with intertrochanteric fractures by meta-analysis. Methods Ran-domized control trials (RCTs) to compare the effect between PFNA and DHS in treatment of adults with intertrochanteric fractures in Chinese and English references were retrieved. Methodology quality of the trials was evaluated, and related data was extracted. Results Nine RCTs were recruited including 392 patients with PFNA and 398 patients with DHS. The average surgery time, volum of intraoperative blood loss, length of operative incision and the postoperative complica-tion rate treated by PFNA were significantly decreased, compared with those by DHS (P < 0. 05); but there were no sig-nificant differences in average hospital stay and fineness rate of Harris hip joint function score in the two fixations (P > 0. 05). Conclusion PFNA in treatment of adults with intertrochanteric fractures is superior to DHS in the surgery time, volume of intraoperative blood loss, the length of operative incision and the postoperative complications rate, but there is not enough evidence to prove that the differences in the average hospital stay and fineness rate of Harris hip joint function score are statistically significant.