中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2012年
12期
1063-1072
,共10页
邢丹%马信龙%马剑雄%王杰%陈阳%徐卫国%杨阳%朱少文%马宝意%冯睿%贾浩波
邢丹%馬信龍%馬劍雄%王傑%陳暘%徐衛國%楊暘%硃少文%馬寶意%馮睿%賈浩波
형단%마신룡%마검웅%왕걸%진양%서위국%양양%주소문%마보의%풍예%가호파
关节成形术,置换,髋%外科手术,微创性%髋关节%髋假体%Meta分析
關節成形術,置換,髖%外科手術,微創性%髖關節%髖假體%Meta分析
관절성형술,치환,관%외과수술,미창성%관관절%관가체%Meta분석
Arthroplasty,replacement,hip%Surgical procedures,minimally invasive%Hip joint%Hip prosthesis%Meta-analysis
目的 通过检索和分析国内外相关文献,应用Meta分析的方法评价微创和传统人工全髋关节置换术(total hip arthroplasty,THA)的临床疗效. 方法 计算机检索MEDLINE、EMBASE、OVID、ScienceDirect等数据库并结合手工检索,按照既定的纳入和排除标准查找有关微创THA与传统THA的临床随机对照试验(randomized controlled trials,RCTs).使用Cochrane风险评估工具对纳入的文献进行方法学质量评价,并使用RevMan 5.1软件进行Meta分析.比较两种手术方式术后Harris评分、手术时间、出血量、并发症等结局指标. 结果 最终纳入17篇文献,共18项RCTs,1 560例患者进行评价,其中微创THA 774例,传统THA 786例.研究结果显示,微创THA与传统THA在切口长度[WMD=-5.93,95％ CI(-7.29,-4.57)]、出血量[SMD=-0.45,95％ CI(-0.77,-0.13)]和术后疼痛视觉评分(visual analog scale,VAS)[MD=-19.58,95％ CI(-26.38,-12.78)]方面的差异均有统计学意义.而在术后Harris评分[WMD=0.85,95％ CI(-3.50,5.20)]、手术时间[WMD=-0.99,95％ CI(-5.36,3.39)]、输血量[WMD=-66.29,95％ CI(-241.31,108.72)]、并发症发生率[RR=1.01,95％ CI(0.61,1.66)]方面的差异均无统计学意义. 结论 尽管微创THA较传统THA的切口小、出血量少、术后疼痛轻,但术后功能的恢复、手术时间、输血量和并发症的发生率与传统THA相当.需进一步开展高质量、多中心、大样本的RCTs去验证.
目的 通過檢索和分析國內外相關文獻,應用Meta分析的方法評價微創和傳統人工全髖關節置換術(total hip arthroplasty,THA)的臨床療效. 方法 計算機檢索MEDLINE、EMBASE、OVID、ScienceDirect等數據庫併結閤手工檢索,按照既定的納入和排除標準查找有關微創THA與傳統THA的臨床隨機對照試驗(randomized controlled trials,RCTs).使用Cochrane風險評估工具對納入的文獻進行方法學質量評價,併使用RevMan 5.1軟件進行Meta分析.比較兩種手術方式術後Harris評分、手術時間、齣血量、併髮癥等結跼指標. 結果 最終納入17篇文獻,共18項RCTs,1 560例患者進行評價,其中微創THA 774例,傳統THA 786例.研究結果顯示,微創THA與傳統THA在切口長度[WMD=-5.93,95％ CI(-7.29,-4.57)]、齣血量[SMD=-0.45,95％ CI(-0.77,-0.13)]和術後疼痛視覺評分(visual analog scale,VAS)[MD=-19.58,95％ CI(-26.38,-12.78)]方麵的差異均有統計學意義.而在術後Harris評分[WMD=0.85,95％ CI(-3.50,5.20)]、手術時間[WMD=-0.99,95％ CI(-5.36,3.39)]、輸血量[WMD=-66.29,95％ CI(-241.31,108.72)]、併髮癥髮生率[RR=1.01,95％ CI(0.61,1.66)]方麵的差異均無統計學意義. 結論 儘管微創THA較傳統THA的切口小、齣血量少、術後疼痛輕,但術後功能的恢複、手術時間、輸血量和併髮癥的髮生率與傳統THA相噹.需進一步開展高質量、多中心、大樣本的RCTs去驗證.
목적 통과검색화분석국내외상관문헌,응용Meta분석적방법평개미창화전통인공전관관절치환술(total hip arthroplasty,THA)적림상료효. 방법 계산궤검색MEDLINE、EMBASE、OVID、ScienceDirect등수거고병결합수공검색,안조기정적납입화배제표준사조유관미창THA여전통THA적림상수궤대조시험(randomized controlled trials,RCTs).사용Cochrane풍험평고공구대납입적문헌진행방법학질량평개,병사용RevMan 5.1연건진행Meta분석.비교량충수술방식술후Harris평분、수술시간、출혈량、병발증등결국지표. 결과 최종납입17편문헌,공18항RCTs,1 560례환자진행평개,기중미창THA 774례,전통THA 786례.연구결과현시,미창THA여전통THA재절구장도[WMD=-5.93,95％ CI(-7.29,-4.57)]、출혈량[SMD=-0.45,95％ CI(-0.77,-0.13)]화술후동통시각평분(visual analog scale,VAS)[MD=-19.58,95％ CI(-26.38,-12.78)]방면적차이균유통계학의의.이재술후Harris평분[WMD=0.85,95％ CI(-3.50,5.20)]、수술시간[WMD=-0.99,95％ CI(-5.36,3.39)]、수혈량[WMD=-66.29,95％ CI(-241.31,108.72)]、병발증발생솔[RR=1.01,95％ CI(0.61,1.66)]방면적차이균무통계학의의. 결론 진관미창THA교전통THA적절구소、출혈량소、술후동통경,단술후공능적회복、수술시간、수혈량화병발증적발생솔여전통THA상당.수진일보개전고질량、다중심、대양본적RCTs거험증.
Objective To collect domestic and foreign literatures on mini-invasive total hiparthroplasty (THA) and conventional THA so as to assay the clinical outcomes of the two treatments usingMeta analysis.Methods Randomized controlled trials (RCTs) of mini-invasive THA and conventionalTHA that met the inclusion criteria were collected in the computer-based retrieval combined with manualretrieval of databases such as MEDLINE,EMBASE,OVID,and ScienceDirect.Methodological qualityassessment of the included literatures was performed using Cochrane risk evaluation tool and Meta analysisof those literatures was made by employing RevMan 5.1 software.Two surgical approaches were comparedin regard of indices including postoperative Harris hip score,operation time,intraoperative blood loss andcomplications.Results The study involved 17 related articles (18 RCTs containing 1 560 patients),including 774 patients treated by mini-invasive THA and 786 by conventional THA.The study showedsignificant differences between mini-invasive THA and conventional THA in aspects of incision length[WMD=-5.93,95％ CI (-7.29,-4.57)],blood loss [SMD =-0.45,95％ CI (-0.77,-0.13)] and postoperative visual analog scale (VAS) [MD =-19.58,95％ CI (-26.38,-12.78)],whereas there were no significant differences regarding the postoperative Harris score [WMD =0.85,95％ CI (-3.50,5.20)],operation time [WMD=-0.99,95％ CI (-5.36,3.39)],blood transfusion volume [WMD =-66.29,95％ CI (-241.31,108.72)] and complication incidence rate [RR =1.01,95％ CI (0.61,1.66)].Conclusions Mini-invasive THA offers advantages of smaller incision,less intraoperative blood loss and milder postoperative pain over conventional THA but has similar effect with conventional THA in aspects of Harris hip score,operation duration,blood transfusion volume and complications.Moreover,high quality,multicenter and large scale RCTs are required to confirm the outcomes.
