CAJ | 학술논문

背景：人工股骨头置换和防旋股骨近端髓内钉在修复老年股骨转子间骨折方面哪种更优尚无定论。目的：通过Meta分析比较国内老年人股骨转子间骨折使用人工股骨头置换与防旋股骨近端髓内钉内固定的疗效差异。方法：检索PubMed、Cochrane、CNKI、万方、维普等数据库，以及《中华骨科杂志》、《中国矫形外科杂志》等近5年发表的相关文献。收集国内老年股骨转子间骨折行人工股骨头置换与防旋股骨近端髓内钉修复的临床对照试验，提取基线资料，采集手术持续时间、术中出血量、术后下床时间、住院时间、Harris 评分、并发症率和死亡数等数据，并用RevMan 5.30对所提取数据结果进行Meta分析处理。结果与结论：共纳入37个临床对照研究，共3216例患者。Meta分析结果显示，与人工股骨头置换相比，防旋股骨近端髓内钉在术后下床、住院时间及早期关节功能方面处于劣势；而两者在并发症及死亡率上差异并无显著性意义。但防旋股骨近端髓内钉具有手术持续时间短、创伤小、术中出血少等优点，也具有较好的中远期关节功能预期效果。
배경：인공고골두치환화방선고골근단수내정재수복노년고골전자간골절방면나충경우상무정론。목적：통과Meta분석비교국내노년인고골전자간골절사용인공고골두치환여방선고골근단수내정내고정적료효차이。방법：검색PubMed、Cochrane、CNKI、만방、유보등수거고，이급《중화골과잡지》、《중국교형외과잡지》등근5년발표적상관문헌。수집국내노년고골전자간골절행인공고골두치환여방선고골근단수내정수복적림상대조시험，제취기선자료，채집수술지속시간、술중출혈량、술후하상시간、주원시간、Harris 평분、병발증솔화사망수등수거，병용RevMan 5.30대소제취수거결과진행Meta분석처리。결과여결론：공납입37개림상대조연구，공3216례환자。Meta분석결과현시，여인공고골두치환상비，방선고골근단수내정재술후하상、주원시간급조기관절공능방면처우열세；이량자재병발증급사망솔상차이병무현저성의의。단방선고골근단수내정구유수술지속시간단、창상소、술중출혈소등우점，야구유교호적중원기관절공능예기효과。
BACKGROUND:Proximal femoral nail antirotation and femoral head replacement could quickly recover hip function in intertrochanteric fractures in the elderly, but whose efficacy is better remains controversial. OBJECTIVE:To compare the differences in the effects of proximal femoral nail antirotation and femoral head replacement on intertrochanteric fractures in the elderly by using a meta-analysis. METHODS:The relevant literatures were searched in PubMed, Cochrane, CNKI, Wanfang database and VIP, and other relevant journal such asChinese Journal of Orthopaedicsand Orthopedic Journal of Chinafor articles published in recent five years. Randomized controled trials concerning proximal femoral nail antirotation and femoral head replacement for the treatment of intertrochanteric fractures in the Chinese elderly were colected. Baseline data, operation time, intraoperative blood loss, postoperative out-of-bed time, length of stay, Harris score, complication rate and number of death were colected and processed using RevMan 5.30 software for meta analysis. RESULTS AND CONCLUSION:Totaly 37 clinical controled trials with 3 216 patients were recruited. Meta-analysis results showed that compared with femoral head replacement, proximal femoral nail antirotation was at a disadvantage in postoperative out-of-bed time, length of stay and joint function in the early stage. No significant difference in complication and mortality was detected between proximal femoral nail antirotation and femoral head replacement. However, proximal femoral nail antirotation had some advantages such as short operation time, smal trauma, and less intraoperative blood loss, and showed good midterm and long-term outcomes of joint function.