CAJ | 학술논문

目的通过Meta分析对骨水泥型股骨头置换治疗高龄患者股骨颈骨折的有效性与安全性进行评价. 方法计算机检索PubMed、Embase、Cochrane图书馆、中国期刊全文数据库、维普中文科技期刊数据库等,检索时间均为建库至2012年12月,获取骨水泥型股骨头置换(骨水泥组)与非骨水泥型股骨头置换(非骨水泥组)治疗高龄患者骨质疏松性股骨颈骨折的随机对照试验.比较两组患者的术后关节功能、病死率、并发症发生率、手术时间、术中出血量及再手术率等.采用RevMan 5.2统计学软件进行Meta分析. 结果共纳入7篇随机对照试验,共1108例患者1115髋.文献质量评价结果显示纳入研究质量较高.Meta分析结果显示:与非骨水泥组比较,骨水泥组患者术后关节功能恢复良好,假体相关并发症发生率更低[OR =0.15,95％ CI(0.09,0.26),P＜0.001],但手术时间延长[MD=7.43,95％ CI(5.37,9.49),P＜0.001].两组患者局部并发症发生率、其他并发症发生率、病死率、术中出血量及再手术率比较差异均无统计学意义(P＞0.05). 结论与非骨水泥型股骨头置换术相比,骨水泥型股骨头置换治疗高龄患者股骨颈骨折虽然手术时间延长,但术中出血量未见明显增加,且具有术后关节功能恢复快、假体相关并发症少等优点,同时不增加病死率及再手术率.
목적 통과Meta분석대골수니형고골두치환치료고령환자고골경골절적유효성여안전성진행평개. 방법 계산궤검색PubMed、Embase、Cochrane도서관、중국기간전문수거고、유보중문과기기간수거고등,검색시간균위건고지2012년12월,획취골수니형고골두치환(골수니조)여비골수니형고골두치환(비골수니조)치료고령환자골질소송성고골경골절적수궤대조시험.비교량조환자적술후관절공능、병사솔、병발증발생솔、수술시간、술중출혈량급재수술솔등.채용RevMan 5.2통계학연건진행Meta분석. 결과 공납입7편수궤대조시험,공1108례환자1115관.문헌질량평개결과현시납입연구질량교고.Meta분석결과현시:여비골수니조비교,골수니조환자술후관절공능회복량호,가체상관병발증발생솔경저[OR =0.15,95％ CI(0.09,0.26),P＜0.001],단수술시간연장[MD=7.43,95％ CI(5.37,9.49),P＜0.001].량조환자국부병발증발생솔、기타병발증발생솔、병사솔、술중출혈량급재수술솔비교차이균무통계학의의(P＞0.05). 결론 여비골수니형고골두치환술상비,골수니형고골두치환치료고령환자고골경골절수연수술시간연장,단술중출혈량미견명현증가,차구유술후관절공능회복쾌、가체상관병발증소등우점,동시불증가병사솔급재수술솔.
Objective To assess the effectiveness and safety of cemented hemiarthroplasty for femoral neck fractures in elderly patients through a mate-analysis of randomized controlled trials (RCTs).Methods RCTs comparing cemented hemiarthroplasty (CH) and uncemented hemiarthroplasty (UCH) for femoral neck fractures before December 2012 were identified from the PubMed,EMBase,Cochrane Library,CNKI and VIP databases through computer search.Relevant references were also searched manually.The eligible RCTs were collected.Next we extracted the relevant data which were evaluated by Review Manager software 5.2 for meta-analysis.Odds ratio (OR) of mortality,the rates of complications and reoperation,weighted mean difference (MD) of operation time and intraoperative blood loss in the CH and UCH groups were calculated across the trials.Descriptive analysis was used for the postoperative hip function.Results Seven RCTs involving 1115 hips met the selection criteria.The methodological quality of all the 7 trials was high.The meta-analysis showed that CH had better postoperative hip function and decreased rate of complications related to the prosthesis [OR =0.15,95％ CI(0.09,0.26),P ＜ 0.001],while UCH achieved shorter operative time [MD =7.43,95％ CI (5.37,9.49),P ＜ 0.001].There was no significant difference between UCH and CH in local complications,other complications,morality,intraoperative blood loss or reoperation rate(P ＞ 0.05).Conclusion Compared with UCH,CH can achieve better postoperative hip function and lower complications related to the prosthesis,and do not increase the intraoperative blood loss,the morality or reoperative rate though it prolongs the operation time.