CAJ | 학술논문

目的：运用Meta分析方法比较股骨近端防旋髓内钉(PFNA)与Gamma3钉治疗成人股骨粗隆间骨折疗效的差异。方法使用计算机检索Pubmed、ScienceDirect、Web of Science、Cochrane数据库、AO/ASIF数据库、中国知网(CNKI)、万方数据库以及维普数据库。收集有关Gamma3钉与PFNA治疗成人股骨粗隆间骨折的各类型对照研究，依据纳入与排除标准选取文献、提取相关数据，使用Cochrane制作的Review Manager 5.3.3进行Meta分析。结果共有10篇文献纳入研究Meta分析结果，提示PFNA组较Gamma3钉组手术时间更短，术中出血量更少。但二者在髋功能评分、髋功能优良率、骨折延迟愈合或不愈合发生率、切口感染率、内固定物切出与移位率以及内固定物周围再骨折率上差异均无统计学意义。结论 PFNA较Gamma3钉有助于缩短手术时间和减少术中失血量，但在疗效方面差异无统计学意义。对于成人的股骨粗隆间骨折，选取上述两种方式都可以取得良好疗效。目前同时开展上述两种手术的医院较少，同时使用完全随机对照的研究数量较少，仍有待进行大样本的随机对照临床实验得出可靠结论。
목적：운용Meta분석방법비교고골근단방선수내정(PFNA)여Gamma3정치료성인고골조륭간골절료효적차이。방법사용계산궤검색Pubmed、ScienceDirect、Web of Science、Cochrane수거고、AO/ASIF수거고、중국지망(CNKI)、만방수거고이급유보수거고。수집유관Gamma3정여PFNA치료성인고골조륭간골절적각류형대조연구，의거납입여배제표준선취문헌、제취상관수거，사용Cochrane제작적Review Manager 5.3.3진행Meta분석。결과공유10편문헌납입연구Meta분석결과，제시PFNA조교Gamma3정조수술시간경단，술중출혈량경소。단이자재관공능평분、관공능우량솔、골절연지유합혹불유합발생솔、절구감염솔、내고정물절출여이위솔이급내고정물주위재골절솔상차이균무통계학의의。결론 PFNA교Gamma3정유조우축단수술시간화감소술중실혈량，단재료효방면차이무통계학의의。대우성인적고골조륭간골절，선취상술량충방식도가이취득량호료효。목전동시개전상술량충수술적의원교소，동시사용완전수궤대조적연구수량교소，잉유대진행대양본적수궤대조림상실험득출가고결론。
Objective Using meta-analysis to assess the effects of proximal femoral nail anti-rotation (PF-NA) and Gamma3 nail in the treatment of intertrochanteric fractures in adults. Methods Researches of comparisons between PFNA and Gamma3 nail in treartment of intertrochanteric fractures in adults were searched from Pubmed, AO/ASIF, ScienceDirect, Web of Science, Cochrane, CNKI, WanFang database and VIP database. Relevant data were extracted according to inclusion and exclusion criteria, and then Statistical software Review Manager 5.3.3 was used to finish the meta-analysis. Results Ten studies were included in the analysis. The results of meta-analysis showed that compared with Gamma3 nail, PFNA had shorter surgical time and lost less blood, but there were no statistically significant differences in the hip function-score, excellent rate of hip function, incidence of delayed union or non-union, wound infection, cut-out or shift of the fixture and re-fracture around the fixture. Conclusion There were no evidences showing that there were any differences between PNFA and Gamma3 nail in the therapeutic effect of treat-ing adult femur intertrochanteric fractures. However, PFNA may cost less time in the operation and lose less blood. At present, there were relatively few hospitals that can carry out the above two kinds of surgery at a same time, and also there were very few completely randomized controlled studies applied. Therefore larger samples of randomized con-trolled trials are needed to obtain a more reliable conclusion.