中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2015年
1期
31-36
,共6页
脊柱骨折%胸椎%腰椎%Meta分析
脊柱骨摺%胸椎%腰椎%Meta分析
척주골절%흉추%요추%Meta분석
Spinal fractures%Thoracic vertebrae%Lumbar vertebrae%Meta analysis
目的 对无神经损伤胸腰椎爆裂骨折手术与非手术治疗进行Meta分析及疗效比较.方法 由2名研究者独立检索Pubmed Medline、荷兰医学文摘数据库(Embase)、Cochrane系统综述数据库和临床对照试验数据库、中国生物医学文献数据库(CBM)、万方数据库、中国知网(CNKI).根据纳入、排除标准筛选各数据库建库至2014年2月发表的文献,并遵循Cochrane指南进行文献质量评价及数据提取. 结果 最终纳入2篇随机对照研究,获取79例患者的临床资料(手术组41例,非手术组38例)进行Meta分析,随访期限最少2年.2篇研究的异质性较大,其中1篇认为随访结束时手术组在疼痛缓解、功能恢复及重返工作方面疗效较好;而另1篇的结果则相反.Meta结果显示,手术组并发症(RR =2.85,95％ CI 0.83 ～9.75)包括再次手术率(RR=8.39,95％CI 1.12 ～62.87)较高. 结论 对于无神经损伤的胸腰椎爆裂骨折,手术与非手术治疗在缓解疼痛、促进功能恢复及患者重返工作方面疗效相似,手术治疗往往带来较多的并发症.
目的 對無神經損傷胸腰椎爆裂骨摺手術與非手術治療進行Meta分析及療效比較.方法 由2名研究者獨立檢索Pubmed Medline、荷蘭醫學文摘數據庫(Embase)、Cochrane繫統綜述數據庫和臨床對照試驗數據庫、中國生物醫學文獻數據庫(CBM)、萬方數據庫、中國知網(CNKI).根據納入、排除標準篩選各數據庫建庫至2014年2月髮錶的文獻,併遵循Cochrane指南進行文獻質量評價及數據提取. 結果 最終納入2篇隨機對照研究,穫取79例患者的臨床資料(手術組41例,非手術組38例)進行Meta分析,隨訪期限最少2年.2篇研究的異質性較大,其中1篇認為隨訪結束時手術組在疼痛緩解、功能恢複及重返工作方麵療效較好;而另1篇的結果則相反.Meta結果顯示,手術組併髮癥(RR =2.85,95％ CI 0.83 ～9.75)包括再次手術率(RR=8.39,95％CI 1.12 ～62.87)較高. 結論 對于無神經損傷的胸腰椎爆裂骨摺,手術與非手術治療在緩解疼痛、促進功能恢複及患者重返工作方麵療效相似,手術治療往往帶來較多的併髮癥.
목적 대무신경손상흉요추폭렬골절수술여비수술치료진행Meta분석급료효비교.방법 유2명연구자독립검색Pubmed Medline、하란의학문적수거고(Embase)、Cochrane계통종술수거고화림상대조시험수거고、중국생물의학문헌수거고(CBM)、만방수거고、중국지망(CNKI).근거납입、배제표준사선각수거고건고지2014년2월발표적문헌,병준순Cochrane지남진행문헌질량평개급수거제취. 결과 최종납입2편수궤대조연구,획취79례환자적림상자료(수술조41례,비수술조38례)진행Meta분석,수방기한최소2년.2편연구적이질성교대,기중1편인위수방결속시수술조재동통완해、공능회복급중반공작방면료효교호;이령1편적결과칙상반.Meta결과현시,수술조병발증(RR =2.85,95％ CI 0.83 ～9.75)포괄재차수술솔(RR=8.39,95％CI 1.12 ～62.87)교고. 결론 대우무신경손상적흉요추폭렬골절,수술여비수술치료재완해동통、촉진공능회복급환자중반공작방면료효상사,수술치료왕왕대래교다적병발증.
Objective To compare the outcomes of operative with non-operative treatment for thoracolumbar burst fracture without neurological deficit using Meta-analysis.Methods Electronic database were searched from inception to February 2014 by two independent reviewers,including Pubmed Medline,Excerpta Medica Database (Embase),Cochrane Central Register of Controlled Trials,Chinese Biology Medicine (CBM),Chinese Wanfang Database,and China National Knowledge Infrastructure (CNKI).Inclusion and exclusion criteria were applied to select the studies.Quality appraisal and data extraction were based on Cochrane Collaboration guidelines.Results Two randomized controlled trials (RCTs),which reported outcomes for 79 patients (41 with operative treatment and 38 with nonoperative treatment) at a follow-up of two years or more were included.Between-study heterogeneity was found to be significant,for one reported better results in surgery group concerning pain relief,function recovery and returning to work.However,opposite results were found in another trial.Meta-analysis showed surgery led to higher complication rates (RR =2.85,95％ CI 0.83-9.75),including subsequent surgery (RR =8.39,95％ CI 1.12-62.87).Conclusion Operative and nonoperative managements produce similar results with respect to pain relief,function regain,and returning to work when performed for thoracolumbar burst fractures without neurologic deficit,but operation is often associated with more complications.
