CAJ | 학술논문

目的对单极与双极股骨头置换治疗老年股骨颈骨折的疗效进行系统评价. 方法计算机检索MEDLINE、EMBASE、Cochrane图书馆和中国生物医学文献数据库,手工检索10种中文杂志,收集所有相关随机对照试验(randomized controlled trial,RCT)及半随机对照试验(quasi-RCT,qRCT).检索时间1966年至2012年7月.采用RevMan 4.2.8行Meta分析. 结果共纳入7个RCT、3个RCT.Meta分析显示,术后6个月与单极股骨头置换对比,双极置换术后髋关节功能优于单极(RR =0.74,95％ CI0.62 ～0.88,P＜0.01),两者术后1年脱位率(RR=1.01,95％CI 0.54～ 1.89,P＞0.05)、再手术率(RR=1.13,95％ CI 0.74～ 1.72,P＞0.05)、主要并发发生率(除外脱位)(RR=1.27,95％ CI 0.74 ～2.18,P＞0.05)和术后2年病死率(RR=1.16,95％ CI0.73 ～ 1.87,P＞0.05)差异无统计学意义. 结论与单极股骨头置换相比,双极股骨头置换术能更好地改善髋关节功能,但术后1年脱位率、再手术率、主要并发症发生率(除外脱位)和术后2年病死率无显著差异.
목적 대단겁여쌍겁고골두치환치료노년고골경골절적료효진행계통평개. 방법 계산궤검색MEDLINE、EMBASE、Cochrane도서관화중국생물의학문헌수거고,수공검색10충중문잡지,수집소유상관수궤대조시험(randomized controlled trial,RCT)급반수궤대조시험(quasi-RCT,qRCT).검색시간1966년지2012년7월.채용RevMan 4.2.8행Meta분석. 결과 공납입7개RCT、3개RCT.Meta분석현시,술후6개월여단겁고골두치환대비,쌍겁치환술후관관절공능우우단겁(RR =0.74,95％ CI0.62 ～0.88,P＜0.01),량자술후1년탈위솔(RR=1.01,95％CI 0.54～ 1.89,P＞0.05)、재수술솔(RR=1.13,95％ CI 0.74～ 1.72,P＞0.05)、주요병발발생솔(제외탈위)(RR=1.27,95％ CI 0.74 ～2.18,P＞0.05)화술후2년병사솔(RR=1.16,95％ CI0.73 ～ 1.87,P＞0.05)차이무통계학의의. 결론 여단겁고골두치환상비,쌍겁고골두치환술능경호지개선관관절공능,단술후1년탈위솔、재수술솔、주요병발증발생솔(제외탈위)화술후2년병사솔무현저차이.
Objective To evaluate the effect of unipolar versus bipolar hemiarthroplasty for treatment of femoral neck fracture in the elderly Methods Related randomized controlled trials (RCTs) and quasi-randomized controlled trials (qRCTs) were searched from computerized databases MEDLINE,EMBASE,Cochrane Library,and CBM disc.Additional studies were identified through hand searches of 10 domestic journals.Time period of the search was from 1966 to June 2012.RevMan 4.2.8 software was used for data analysis.Results A total of 7 RCTs and 3 qRCTs were included.In this meta analysis,bipolar hemiarthroplasty was associated with better hip function compared with unipolar hemiarthroplasty at postoperative 6 months (RR =0.74,95％ CI0.62-0.88,P ＜ 0.01).However,the two procedures revealed no significant differences in terms of postoperative one-year dislocation rate (RR =1.01,95％ CI0.54-1.89,P ＞ 0.05),reoperation rate (RR =1.13,95％ CI 0.74-1.72,P ＞ 0.05),major complication incidence (except for dislocation) (RR =1.27,95％ CI 0.74-2.18,P ＞ 0.05),and postoperative 2-year mortality (RR1.16,95％ CI 0.73-1.87,P ＞ 0.05).Conclusion Bipolar hemiarthroplasty is preferable to unipolar hemiarthroplasty for hip function improvement,but postoperative one-year dislocation rate,reoperation rate,major complication incidence (except for dislocation),and postoperative twoyear mortality are similar for the two procedures.