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[1]張磊,柴浩.股骨近端髓內釘與動力髖螺釘固定治療 老年股骨轉子間骨折的系統(tǒng)評價[J].中醫(yī)正骨,2015,27(03):27-31.
　ZHANG Lei,CHAI Hao.Systematic review on proximal femoral nail versus dynamic hip screw fixation for treatment of intertrochanteric fracture in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):27-31.
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股骨近端髓內釘與動力髖螺釘固定治療 老年股骨轉子間骨折的系統(tǒng)評價()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年03期
頁碼:
27-31
欄目:
文獻研究
出版日期:
2015-03-30

文章信息/Info

Title:
Systematic review on proximal femoral nail versus dynamic hip screw fixation for treatment of intertrochanteric fracture in the aged
作者:
張磊1; 柴浩2
1.中國人民武裝警察部隊新疆生產建設兵團指揮部后勤部醫(yī)院,新疆 烏魯木齊 830000;
2.新疆醫(yī)科大學第六附屬醫(yī)院,新疆 烏魯木齊 830002
Author(s):
ZHANG Lei1; CHAI Hao2
1.The logistics department hospital affiliated to Xinjiang Production and Construction corps headquarters of Chinese People's Armed Police Forces,Urumchi 830000,Xinjiang,China
2.The Sixth Affiliated Hospital of Xinjiang Medical University,Urumchi 830002,Xinjiang,China
關鍵詞:
髖骨折;  轉子間骨折;  股骨近端髓內釘;  動力髖螺釘;  Meta分析
Keywords:
hip fractures;  intertrochanteric fractures;  proximal femoral nail;  dynamic hip screw;  Meta-analysis
摘要:
目的:評價股骨近端髓內釘(proximal femoral nail,PFN)和動力髖螺釘(dynamic hip screw,DHS)固定治療老年股骨轉子間骨折的臨床療效和安全性。方法:英文數(shù)據(jù)庫以trochanteric fracture AND dynamic hip screw(DHS)AND proximal femoral nail(PFN)AND randomized controlled trials(RCT)OR quasi-RCT為檢索詞; 中文數(shù)據(jù)庫以股骨粗隆間骨折AND動力髖螺釘AND股骨近端髓內釘 AND 隨機對照,股骨轉子間骨折AND動力髖螺釘AND股骨近端髓內釘AND隨機對照為檢索詞。以計算機檢索Medline、Embase、Cochrane圖書館、Cochrane協(xié)作網專業(yè)實驗數(shù)據(jù)庫、中國生物醫(yī)學文獻數(shù)據(jù)庫、中國知網、萬方學術期刊數(shù)據(jù)庫及中文科技期刊全文數(shù)據(jù)庫建庫至2014年4月的所有相關文獻。采用Cochrane國際協(xié)作組織提供的ReviewManager4.2.10軟件進行統(tǒng)計分析。結果:共檢索出文獻181篇,經過篩選最終納入9篇文獻,其中英文文獻3篇、中文文獻6篇,共涉及1236例患者。PFN組較DHS組手術時間短、術中出血量少、手術優(yōu)良率高[OR=-2.730,95%CI(-2.95,-2.51); OR=-1.900,95%CI(-2.09,-1.71); OR=2.480,95%CI(1.38,4.48)]。2組的螺釘切出率及再次手術率比較,組間差異均無統(tǒng)計學意義[OR=1.290,95%CI(0.39,4.29); OR=1.740,95%CI(0.61,4.95)]。結論:與DHS固定相比,PFN固定治療老年股骨轉子間骨折手術時間短、出血量少、手術優(yōu)良率高,二者的安全性相當。
Abstract:
Objective:To compare the clinical curative effect and safety between proximal femoral nail(PFN)fixation and dynamic hip screw(DHS)fixation in the treatment of intertrochanteric fracture in the aged.Methods:The logical combination of trochanteric fracture,dynamic hip screw(DHS),proximal femoral nail(PFN)and randomized controlled trials(RCT)or quasi-RCT were chosen as index terms.All the relevant literatures included from database establishing to April 2014 were retrieved from Medline,Embase,Cochrane library,Cochrane collaboration,Chinese Biomedical Disc(CBMdisc),China national knowledge internet,Wanfang Database and China Science and Technology Journal Full-text Database through computer.Statistical analysis was conducted by using ReviewManager4.2.10 software provided by Cochrane collaboration networks.Results:One hundred and eighty-one literatures were searched out.After screening,9 literatures(1236 patients)were included in the final analysis,including three English literatures and six Chinese literatures.The result of Meta-analysis demonstrated that PFN has shorter operative time,less blood loss and better curative effect compared to DHS(OR=-2.730,95%CI(-2.95,-2.51); OR=-1.900,95%CI(-2.09,-1.71); OR=2.480,95%CI(1.38,4.48)).There was no statistical difference in the incidence rate of screw protrusion and reoperation between the two groups(OR=1.290,95%CI(0.39,4.29); OR=1.740,95%CI(0.61,4.95)).Conclusion:PFN fixation has shorter operative time,less blood loss and better curative effect compared to DHS fixation for treatment of intertrochanteric fractures in the aged patients,while they are similar to each other in safety.

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備注/Memo

備注/Memo:
2014-11-26收稿 2015-01-08修回
更新日期/Last Update: 2015-03-30