CAJ | 학술논문

背景:目前,自体髂骨移植被广泛认为是治疗骨缺损的“金标准”;然而,髂嵴供骨区常出现并发症,限制了其在临床上的推广使用.目的:采用循证医学研究方法,对已发表相关文献进行汇总分析,总结自体髂骨植骨后供骨区并发症的种类及发生率.方法:检索 PubMed Medline、Ovid Medline、Cochrane Database、Embase Database 等数据库,检索时间范围:2002年1月至2011年12月,以“Iliac crest bone graft”或“autologous bone graft”或“bone graft donor site”或“complication”或“Morbidity”为检索词,共检索到174篇文献.根据检索条件及评价标准,最终筛选出30篇临床研究报道进行 Meta 分析,共计2476例患者.采用 SPSS 13.0和 R 软件及其 Meta 程序包对检索结果进行统计分析.结果与结论:自体髂骨植骨后供骨区主要并发症包括供骨区≥6个月长期疼痛(发生率=7.88%,95%可信区间4.76%-12.79%)、供骨区感染(发生率=4.26%,95%可信区间2.95%-6.12%)、血肿及血清肿(发生率=6.55%,95%可信区间4.90%-8.70%)、神经损伤(发生率=5.85%,95%可信区间3.46%-9.71%)、感觉障碍(发生率=10.1%,95%可信区间6.07%-16.23%).可见髂骨取骨后并发症发生率较高,临床医师应予以重视.
배경:목전,자체가골이식피엄범인위시치료골결손적“금표준”;연이,가척공골구상출현병발증,한제료기재림상상적추엄사용.목적:채용순증의학연구방법,대이발표상관문헌진행회총분석,총결자체가골식골후공골구병발증적충류급발생솔.방법:검색 PubMed Medline、Ovid Medline、Cochrane Database、Embase Database 등수거고,검색시간범위:2002년1월지2011년12월,이“Iliac crest bone graft”혹“autologous bone graft”혹“bone graft donor site”혹“complication”혹“Morbidity”위검색사,공검색도174편문헌.근거검색조건급평개표준,최종사선출30편림상연구보도진행 Meta 분석,공계2476례환자.채용 SPSS 13.0화 R 연건급기 Meta 정서포대검색결과진행통계분석.결과여결론:자체가골식골후공골구주요병발증포괄공골구≥6개월장기동통(발생솔=7.88%,95%가신구간4.76%-12.79%)、공골구감염(발생솔=4.26%,95%가신구간2.95%-6.12%)、혈종급혈청종(발생솔=6.55%,95%가신구간4.90%-8.70%)、신경손상(발생솔=5.85%,95%가신구간3.46%-9.71%)、감각장애(발생솔=10.1%,95%가신구간6.07%-16.23%).가견가골취골후병발증발생솔교고,림상의사응여이중시.
BACKGROUND: Recently, autologous iliac crest bone graft is considered to be the “gold standard” therapeutic method for bone defects. However, there are some complications in iliae crest bone donor site, and the clinical application is limited. OBJECTIVE: To compiled analyze the published articles and evaluate the types of complications and morbidity fol owing autologous iliac crest bone graft by employing evidence-based medicine method. METHODS: A computer-based online search in PubMed Medline database, Ovid Medline database, Cochrane database and Embase database was performed using key words of “Iliac crest bone graft”,“autologous bone graft”, “bone graft donor site”, “complication” or “morbidity” in English. The published dates were limited between January 2002 and December 2011. A total of 174 articles were searched. Then 30 articles, involving 2476 patients, were selected for the clinical Meta analysis according to retrieval conditions and inclusion criteria. Al relevant data were extracted and analyzed using SPSS 13.0 and R software and its Meta package. RESULTS AND CONCLUSION: The result indicated that the complications of autologous iliac crest bone graft in donor site included chronic pain (≥6 months) [incidence rates=7.88%,95% confidence interval (CI) 4.76-12.79], infection(incidence rate=4.26%, 95% CI 2.95-6.12]), hematoma or seroma (incidence rate=6.55%, 95% CI 4.90-8.70), nerve injury (incidence rates=5.85%, 95% CI 3.46-9.71), sensory disturbance (incidence rate=10.1%, 95% CI 6.07-16.23) respectively. The postoperative complications of autologous iliac crest bone graft are common; therefore, it should be emphasized by clinicians.