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[1]漆國(guó)棟,文化,漆偉,等.手術(shù)與非手術(shù)治療肱骨干骨折安全性的Meta分析[J].中醫(yī)正骨,2021,33(08):33-38.
　QI Guodong,WEN Hua,QI Wei,et al.Comparison of the safety of surgical treatment versus nonsurgical treatment for humeral shaft fractures:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(08):33-38.
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手術(shù)與非手術(shù)治療肱骨干骨折安全性的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年08期
頁(yè)碼:
33-38
欄目:
文獻(xiàn)研究
出版日期:
2021-08-20

文章信息/Info

Title:
Comparison of the safety of surgical treatment versus nonsurgical treatment for humeral shaft fractures:a meta-analysis
作者:
漆國(guó)棟1; 文化1; 漆偉1; 江瓊2; 張雪2; 李姝君2
(1.重慶市中醫(yī)骨科醫(yī)院,重慶 400010; 2.重慶醫(yī)科大學(xué)中醫(yī)藥學(xué)院,重慶 400016)
Author(s):
QI Guodong1; WEN Hua1; QI Wei1; JIANG Qiong2; ZHANG Xue2; LI Shujun2
1.Chongqing Orthopaedic Hospital of Traditional Chinese medicine,Chongqing 400010,China2.College of Traditional Chinese Medicine.CQMU,Chongqing 400016,China
關(guān)鍵詞:
肱骨骨折;  手術(shù)中并發(fā)癥;  手術(shù)后并發(fā)癥;  外科手術(shù);  非手術(shù)治療;  Meta分析;  系統(tǒng)評(píng)價(jià)
Keywords:
humeral fractures;  intraoperative complications;  postoperative complications;  surgical procedures; operative;  non-surgical treatment;  meta analysis;  systematic review
摘要:
目的:比較手術(shù)與非手術(shù)治療肱骨干骨折的安全性。方法:應(yīng)用計(jì)算機(jī)檢索PubMed、EMbase、Cochrane Library、中國(guó)知網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)和維普網(wǎng)2011年1月至2021年1月收錄的對(duì)比手術(shù)和非手術(shù)治療肱骨干骨折的臨床研究文獻(xiàn)。由2名研究者根據(jù)納入、排除標(biāo)準(zhǔn)及統(tǒng)一的文獻(xiàn)信息提取表獨(dú)立檢索、篩選文獻(xiàn)并提取數(shù)據(jù),采用ROBINS-I和Cochrane偏倚風(fēng)險(xiǎn)評(píng)估工具對(duì)納入文獻(xiàn)的質(zhì)量進(jìn)行評(píng)估,采用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果:共檢索出658篇文獻(xiàn),最終納入9篇文獻(xiàn),共涉及1513例肱骨干骨折患者,其中889例接受手術(shù)治療、624例接受非手術(shù)治療。Meta分析結(jié)果顯示,手術(shù)組骨折不愈合率、骨折畸形愈合率、皮膚不良反應(yīng)率均低于非手術(shù)組[I2=28%,P=0.230,OR=0.32,95%CI(0.19,0.54); I2=0%,P=0.470,OR=0.06,95%CI(0.01,0.23); I2=0%,P=0.950,OR=0.09,95%CI(0.02,0.49)],手術(shù)組骨折延遲愈合率、醫(yī)源性神經(jīng)損傷率、手術(shù)部位感染率均高于非手術(shù)組[I2=44%,P=0.150,OR=1.64,95%CI(0.94,2.86); I2=0%,P=0.940,OR=4.75,95%CI(1.55,14.57); I2=0%,P=0.930,OR=3.63,95%CI(0.93,14.17)]。結(jié)論:現(xiàn)有的證據(jù)表明,相較于非手術(shù)治療,手術(shù)治療肱骨干骨折的骨折不愈合率、畸形愈合率和皮膚不良反應(yīng)率均較低,而骨折延遲愈合率、醫(yī)源性神經(jīng)損傷率和手術(shù)部位感染率均較高。
Abstract:
Objective:To compare the safety of surgical treatment versus nonsurgical treatment for humeral shaft fractures.Methods:All articles concerning surgical treatment(surgical group)versus nonsurgical treatment(non-surgical group)for humeral shaft fractures that published at home and abroad included from January 2011 to January 2021 were retrieved from PubMed,EMbase,Cochrane Library,China National Knowledge Internet,WanFang Database and VIP Database through computer.The articles were retrieved and screened and the information was extracted independently by two researchers according to the inclusion and exclusion criteria as well as unified literature information extraction table.The methodological quality of research in the articles was evaluated by using ROBINS-Iand Cochrane bias risk assessment tools and a Meta-analysis was conducted by using RevMan 5.3 software.Results:Six hundred and fifty-eight articles were searched out.After screening,9 articles(1513 patients)were included in the final analysis,889 patients in surgical group and 624 patients in nonsurgical group.The results of Meta-analysis revealed that the fracture nonunion rate,fracture malunion rate and skin adverse reaction rate were lower in surgical group compared to nonsurgical group(I2=28%,P=0.230,OR=0.32,95%CI(0.19,0.54); I2=0%,P=0.470,OR=0.06,95%CI(0.01,0.23); I2=0%,P=0.950,OR=0.09,95%CI(0.02,0.49)); while the fracture delayed union rate,iatrogenic nerve injury rate and surgical site infection rate were higher in surgical group compared to nonsurgical group(I2=44%,P=0.150,OR=1.64,95%CI(0.94,2.86); I2=0%,P=0.940,OR=4.75,95%CI(1.55,14.57); I2=0%,P=0.930,OR=3.63,95%CI(0.93,14.17)).Conclusion:Available evidences suggest that the fracture nonunion rate,fracture malunion rate and skin adverse reaction rate are lower,whereas the fracture delayed union rate,iatrogenic nerve injury rate and surgical site infection rate are higher in patients undergoing surgical treatment compared to nonsurgical treatment for humeral shaft fractures.

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備注/Memo

備注/Memo:
基金項(xiàng)目:重慶市科衛(wèi)聯(lián)合中醫(yī)藥技術(shù)創(chuàng)新與應(yīng)用發(fā)展項(xiàng)目(2021ZY023901); 重慶市名老中醫(yī)藥專(zhuān)家傳承工作室建設(shè)項(xiàng)目(渝中醫(yī)〔2020〕20號(hào)17)
通訊作者:漆偉 E-mail:[email protected]
更新日期/Last Update: 1900-01-01