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[1]吳卓檀,蘭榮玉,張衛(wèi)華,等.椎體支架成形術與經皮椎體后凸成形術治療骨質疏松性椎體壓縮骨折有效性和安全性的Meta分析[J].中醫(yī)正骨,2024,36(04):37-46.
　WU Zhuotan,LAN Rongyu,ZHANG Weihua,et al.Clinical outcomes and safety of vertebral body stenting versus percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(04):37-46.
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椎體支架成形術與經皮椎體后凸成形術治療骨質疏松性椎體壓縮骨折有效性和安全性的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數:
2024年04期
頁碼:
37-46
欄目:
文獻研究
出版日期:
2024-04-20

文章信息/Info

Title:
Clinical outcomes and safety of vertebral body stenting versus percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta-analysis
作者:
吳卓檀1; 蘭榮玉2; 張衛(wèi)華2; 申婷婷1; 韓林軒2; 吳曉飛2; 何炳坤3; 任曉平2
1.廣西中醫(yī)藥大學研究生院,廣西 南寧 530001; 2.廣西中醫(yī)藥大學附屬瑞康醫(yī)院,廣西 南寧 530011; 3.廣西中醫(yī)藥大學第一附屬醫(yī)院,廣西 南寧 530023
Author(s):
WU Zhuotan1; LAN Rongyu2; ZHANG Weihua2; SHEN Tingting1; HAN Linxuan2; WU Xiaofei2; HE Bingkun3; REN Xiao-ping2
1.Postgraduate College of Guangxi University of Chinese Medicine,Nanning 530001,Guangxi,China 2.Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530011,Guangxi,China 3.The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,Guangxi,China
關鍵詞:
脊柱骨折;  骨質疏松性骨折;  骨折; 壓縮性;  后凸成型術;  椎體支架成形術;  專題Meta分析
Keywords:
spinal fractures;  osteoporotic fractures;  fractures; compression;  kyphoplasty;  vertebral body stenting;  meta-analysis as topic
摘要:
目的:系統(tǒng)評價椎體支架成形術(vertebral body stenting,VBS)和經皮椎體后凸成形術(percutaneous kyphoplasty,PKP)治療骨質疏松性椎體壓縮骨折(osteoporotic vertebral compression fracture,OVCF)的有效性和安全性。方法:應用計算機檢索中國知網、萬方數據庫、維普網、中國生物醫(yī)學文獻服務系統(tǒng)、PubMed、Web of Science、Embase和Cochrane Library中VBS和PKP治療OVCF的對比研究文獻,檢索時限均為建庫起至2023年12月20日。試驗組采用VBS治療,對照組采用PKP治療,且均采用雙側椎弓根入路。2名研究人員分別獨立進行文獻篩選、數據提取和納入研究的質量評價。采用Stata18.0軟件進行Meta分析。結果:共檢索到196篇文獻,最終納入10篇文獻,共涉及707例患者,其中試驗組353例、對照組354例。Meta分析結果顯示,試驗組的手術時間長于對照組[WMD=9.02,95%CI(2.72,15.32),P=0.005],骨水泥填充量多于對照組[WMD=1.00,95%CI(0.34,1.65),P=0.003],術后傷椎后凸Cobb角、局部后凸Cobb角均小于對照組[WMD=-3.16,95%CI(-5.22,-1.10),P=0.003; WMD=-1.87,95%CI(-2.11,-1.64),P=0.000],術后Beck指數大于對照組[WMD=0.16,95%CI(0.11,0.20),P=0.000],2組術中出血量、住院時間、骨水泥滲漏發(fā)生率、其他不良事件發(fā)生率的差異均無統(tǒng)計學意義[WMD=0.19,95%CI(-0.18,0.55),P=0.317; WMD=0.09,95%CI(-0.12,0.29),P=0.410; RR=0.96,95%CI(0.69,1.32),P=0.799; RR=0.39,95%CI(0.06,2.34),P=0.301]。結論:現有證據表明,VBS手術時間長于PKP,骨水泥填充量多于PKP,在恢復和維持傷椎正常形態(tài)方面優(yōu)于PKP,二者在術中出血量、住院時間及安全性方面相當。
Abstract:
Objective:To systematically review the clinical outcomes and safety of vertebral body stenting(VBS)versus percutaneous kyphoplasty(PKP)for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:All the comparative study articles about VBS versus PKP for treatment of OVCF included from database's inception to December 20,2023 were retrieved from the China National Knowledge Infrastructure,Wanfang Database,Vip Database,Chinese Biomedical Literature Service System,PubMed,Web of Science,Embase and Cochrane Library through computer.The patients in experiment group were treated with VBS through bipedicular approach,while the ones in control group with PKP through bipedicular approach.The articles were screened,the information was extracted and the methodological quality of included researches in the articles was evaluated independently by two researchers,and then a Meta-analysis was conducted by using Stata18.0 software.Results:One hundred and ninety-six articles were searched out.After screening,10 articles(707 patients)were included in the final analysis,353 patients in experiment group and 354 ones in control group.The results of Meta-analysis revealed that the operative time was longer,the consumption of bone cements was more,the postoperative injured vertebrae kyphosis Cobb's angle and local kyphosis Cobb's angle were smaller,the postoperative Beck index was greater in experiment group compared to control group(WMD=9.02,95%CI(2.72,15.32),P=0.005; WMD=1.00,95%CI(0.34,1.65),P=0.003; WMD=-3.16,95%CI(-5.22,-1.10),P=0.003; WMD=-1.87,95%CI(-2.11,-1.64),P=0.000; WMD=0.16,95%CI(0.11,0.20),P=0.000); while,there was no statistical difference in intraoperative blood loss,hospital stay,incidence rate of bone cement leakage and adverse events between the 2 groups(WMD=0.19,95%CI(-0.18,0.55),P=0.317; WMD=0.09,95%CI(-0.12,0.29),P=0.410; RR=0.96,95%CI(0.69,1.32),P=0.799; RR=0.39,95%CI(0.06,2.34),P=0.301).Conclusion:Available evidences suggest that VBS consumes more operative time and bone cements compared to PKP,while,it outperforms PKP in restoring and maintaining the normal morphology of injured vertebra.However,the both are comparable in intraoperative blood loss,hospital stay,and safety.

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備注/Memo

備注/Memo:
基金項目:國家自然科學基金項目(82060874); 廣西重點研發(fā)計劃項目(桂科ZY21195041) 通訊作者:任曉平 E-mail:[email protected]
更新日期/Last Update: 1900-01-01