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[1]孫振國,李恒,楊紅航,等.SuperPATH入路與后外側(cè)入路全髖關(guān)節(jié)置換術(shù)治療髖部疾病的療效系統(tǒng)評(píng)價(jià)[J].中醫(yī)正骨,2018,30(01):32-37,40.
　SUN Zhenguo,LI Heng,YANG Honghang,et al.Systematic review on the curative effect of total hip arthroplasty through supercapsular percutaneously-assisted total hip approach versus posterolateral approach for treatment of hip diseases[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(01):32-37,40.
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SuperPATH入路與后外側(cè)入路全髖關(guān)節(jié)置換術(shù)治療髖部疾病的療效系統(tǒng)評(píng)價(jià)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年01期
頁碼:
32-37,40
欄目:
文獻(xiàn)研究
出版日期:
2018-01-20

文章信息/Info

Title:
Systematic review on the curative effect of total hip arthroplasty through supercapsular percutaneously-assisted total hip approach versus posterolateral approach for treatment of hip diseases
作者:
孫振國; 李恒; 楊紅航; 閔繼康
浙江省湖州市第一人民醫(yī)院,浙江 湖州 313000
Author(s):
SUN Zhenguo; LI Heng; YANG Honghang; MIN Jikang
The First People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 髖;  SuperPATH;  后外側(cè)入路;  Meta分析;  系統(tǒng)評(píng)價(jià)
Keywords:
Keywords arthroplasty; replacement; hip;  supercapsular percutaneously-assisted total hip;  posterolateral approach;  Meta-analysis;  systematic review
摘要:
目的:評(píng)價(jià)SuperPATH入路和后外側(cè)入路全髖關(guān)節(jié)置換術(shù)(total hip arthroplasty,THA)治療髖部疾病的臨床療效。方法:應(yīng)用計(jì)算機(jī)檢索Cochrane Library、Pubmed、Embase、Medline、CBM、CNKI建庫至2017年5月國內(nèi)外公開發(fā)表的SuperPATH入路(SuperPATH入路組)與后外側(cè)入路(后外側(cè)入路組)THA療效比較的隨機(jī)對(duì)照研究文獻(xiàn)或觀察性研究文獻(xiàn)。由2位研究者獨(dú)立篩選文獻(xiàn)、提取資料,依據(jù)Cochrane手冊(cè)和NOS量表進(jìn)行文獻(xiàn)方法學(xué)質(zhì)量評(píng)價(jià)后,采用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果:最初檢出62篇相關(guān)文獻(xiàn),經(jīng)篩選最終納入4篇文獻(xiàn),均為中文文獻(xiàn)。3篇文獻(xiàn)為隨機(jī)對(duì)照研究文獻(xiàn),均未提及具體的隨機(jī)方法,且均未詳細(xì)提及應(yīng)用盲法; 1篇為觀察性研究文獻(xiàn)。納入的研究對(duì)象共266例,SuperPATH入路組120例、后外側(cè)入路組146例。Meta分析結(jié)果顯示,SuperPATH入路組的切口長度小于后外側(cè)入路組[SMD=-7.51,95%CI(-8.88,-6.13)]、術(shù)后臥床時(shí)間比后外側(cè)入路組短[SMD=-3.53,95%CI(-3.98,-3.07)]、住院時(shí)間比后外側(cè)入路組短[SMD=-2.54,95%CI(-4.50,-0.59)]; 2組的手術(shù)時(shí)間[SMD=0.68,95%CI(-0.17,1.54)]、術(shù)中出血量[SMD=-0.17,95%CI(-3.87,3.52)]、術(shù)后1個(gè)月Harris髖關(guān)節(jié)功能評(píng)分[SMD=0.17,95%CI(-0.29,0.63)]、術(shù)后3個(gè)月Harris髖關(guān)節(jié)功能評(píng)分[SMD=0.28,95%CI(-0.01,0.56)]、術(shù)后3個(gè)月雙下肢長度差值[SMD=-0.76,95%CI(-3.64,2.11)]、髖臼外展角[SMD=-0.26,95%CI(-0.53,0.01)]、髖臼前傾角[SMD=0.54,95%CI(-0.76,1.84)]比較,組間差異均無統(tǒng)計(jì)學(xué)意義。利用術(shù)后臥床時(shí)間及住院時(shí)間進(jìn)行發(fā)表偏倚分析,漏斗圖顯示兩側(cè)基本對(duì)稱。結(jié)論:SuperPATH入路THA與后外側(cè)入路THA治療髖部疾病的臨床療效相當(dāng),但前者能夠顯著減少軟組織損傷,有利于患者快速康復(fù)。
Abstract:
ABSTRACT Objective:To evaluate the clinical curative effect of total hip arthroplasty(THA)through supercapsular percutaneously-assisted total hip(SuperPATH)approach versus posterolateral approach for treatment of hip diseases.Methods:All the randomized controlled trial(RCT)articles and observational research articles about the curative effect of THA through SuperPATH approach(SuperPATH approach group)versus posterolateral approach(posterolateral approach group)for treatment of hip diseases that published at home and abroad included from database establishing to May 2017 were retrieved from Cochrane Library,Pubmed,Embase,Medline,CBM and China national knowledge internet through computer.The articles were screened and the information was extracted independently by two searchers.The methodological quality of research in the articles was evaluated according to Cochrane handbook and NOS scale and a Meta-analysis was conducted by using Revman 5.3 software.Results:Sixty-two articles were searched out in the initial stage.After screening,4 Chinese articles(266 patients)were included in the final analysis,including 3 RCT articles(in which randomization method and blind method were not mentioned)and 1 observational research article,and 120 patients in SuperPATH approach group and 146 patients in posterolateral approach group.The results of Meta-analysis demonstrated that the incision length was less and the postoperative bed rest time and the hospital stay were shorter in SuperPATH approach group compared to posterolateral approach group[SMD=-7.51,95%CI(-8.88,-6.13); SMD=-3.53,95%CI(-3.98,-3.07); SMD=-2.54,95%CI(-4.50,-0.59)].There were no statistical difference in operative time[SMD=0.68,95%CI(-0.17,1.54)],intraoperative blood loss[SMD=-0.17,95%CI(-3.87,3.52)],Harris hip function scores at 1 month after surgery[SMD=0.17,95%CI(-0.29,0.63)],Harris hip function scores at 3 months after surgery[SMD=0.28,95%CI(-0.01,0.56)],the difference in length between bilateral lower limbs at 3 months after surgery[SMD=-0.76,95%CI(-3.64,2.11)],acetabular abduction angles[SMD=-0.26,95%CI(-0.53,0.01)]and acetabular anteversion angles[SMD=0.54,95%CI(-0.76,1.84)]between the 2 groups.The result of analysis of publication bias according to postoperative bed rest time and hospital stay showed that the funnel-plot was essentially bilateral symmetry.Conclusion:THA through SuperPATH approach and THA through posterolateral approach are similar to each other in the clinical curative effects in treatment of hip diseases,however,the former can significantly reduce the soft-tissue damage and it is beneficial to patient's quick recovery.

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備注/Memo

備注/Memo:
基金項(xiàng)目:浙江省自然科學(xué)基金資助項(xiàng)目(LY14H060001); 浙江省科技計(jì)劃項(xiàng)目(2017C33227); 浙江省湖州市科學(xué)技術(shù)局公益性應(yīng)用研究項(xiàng)目(2016GY26) 通訊作者:閔繼康 E-mail:[email protected]
更新日期/Last Update: 2018-06-02