CAJ | 학술논문

背景:有关肩锁关节脱位治疗的报道很多,虽然采用的手术方式和固定材料存在差异,但总体而言可分为两大类,即肩锁固定和喙锁固定.究竟何种方式疗效更佳,目前还存在很大的争议.目的:应用 Meta 分析的方法对比肩锁固定和喙锁固定治疗肩锁关节脱位的疗效.方法:计算机检索 Pubmed(1950年1月至2011年10月)、EMBASE(1966年1月至2011年10月)、维普中文科技期刊数据库(1989年1月至2011年10月)、万方数据库(1982年1月至2011年10月)及中国知网数据库(1979年1月至2011年10月)中有关比较肩锁固定和喙锁固定治疗肩锁关节脱位的随机对照试验,按照文中所述纳入标准搜集后进行对比,利用 RevMan5.0软件进行异质性分析及 Meta 分析,绘制森林图.结果与结论:共9篇文章(473例患者,473侧肩锁关节)符合纳入标准.Meta 分析结果显示,肩锁固定与喙锁固定治疗肩锁关节脱位的固定后肩关节功能评分差异无显著性意义,两者在固定后上肢肌力、肩关节活动度、固定后再次脱位率等指标变化上差异亦无显著性意义.因此临床上肩锁关节脱位的治疗不强求采用肩锁固定或是喙锁固定,可根据患者病情、所在医院的条件及术者对不同手术方法的熟悉程度等条件来选择合适的固定方式.
배경:유관견쇄관절탈위치료적보도흔다,수연채용적수술방식화고정재료존재차이,단총체이언가분위량대류,즉견쇄고정화훼쇄고정.구경하충방식료효경가,목전환존재흔대적쟁의.목적:응용 Meta 분석적방법대비견쇄고정화훼쇄고정치료견쇄관절탈위적료효.방법:계산궤검색 Pubmed(1950년1월지2011년10월)、EMBASE(1966년1월지2011년10월)、유보중문과기기간수거고(1989년1월지2011년10월)、만방수거고(1982년1월지2011년10월)급중국지망수거고(1979년1월지2011년10월)중유관비교견쇄고정화훼쇄고정치료견쇄관절탈위적수궤대조시험,안조문중소술납입표준수집후진행대비,이용 RevMan5.0연건진행이질성분석급 Meta 분석,회제삼림도.결과여결론:공9편문장(473례환자,473측견쇄관절)부합납입표준.Meta 분석결과현시,견쇄고정여훼쇄고정치료견쇄관절탈위적고정후견관절공능평분차이무현저성의의,량자재고정후상지기력、견관절활동도、고정후재차탈위솔등지표변화상차이역무현저성의의.인차림상상견쇄관절탈위적치료불강구채용견쇄고정혹시훼쇄고정,가근거환자병정、소재의원적조건급술자대불동수술방법적숙실정도등조건래선택합괄적고정방식.
BACKGROUND: A lot of reports focus on the treatment of acromioclavicular joint dislocations with many differences on the methods and implants. The methods for treatment of the acromioclavicular joint dislocations which used more often in clinic are acromioclavicular fixation and coracoclavicular fixation. There exists great controversy on which method is better. OBJECTIVE: To compare the curative effects between acromioclavicular fixation and coracoclavicular fixation for acromioclavicular joint dislocations through Meta-analysis. METHODS: Related randomized control ed trials on acromioclavicular fixation and coracoclavicular fixation for acromioclavicular joint dislocations were searched in PubMed database (1950-01/2011-10), EMBASE database (1966-01/2011-10), CNKI database (1979-01/2011-10), Wanfang database (1982-01/2011-10) and VIP database (1989-01/2011-10). The articles were col ected according to the inclusion criteria and then compared. Heterogeneity analysis and Meta-analysis were performed using RevMan5.0 software, and then the forest graph was made. RESULTS AND CONCLUSION: Nine articles involving 473 patients and 473 acromioclavicular joints were accepted in our Meta-analysis. There were no significant differences in curative effect score, strength of upper limbs, shoulder movement, re-dislocations rate between acromioclavicular fixation and coracoclavicular fixation. Therefore, the clinical treatment of acromioclavicular joint dislocation can not only use the acromioclavicular fixed or coracoclavicular fixation, doctors should choose the best method according to the patients' condition, hospital conditions and the surgery proficiency of the doctor.