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[1]孫振國,李恒,楊紅航,等.SuperPATH入路與后外側入路全髖關節(jié)置換術治療髖部疾病的療效系統(tǒng)評價[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入路與后外側入路全髖關節(jié)置換術治療髖部疾病的療效系統(tǒng)評價()
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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 ZhenguoLI HengYANG HonghangMIN Jikang
The First People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China
關鍵詞:
關節(jié)成形術置換 SuperPATH 后外側入路 Meta分析 系統(tǒng)評價
Keywords:
Keywords arthroplastyreplacementhip supercapsular percutaneously-assisted total hip posterolateral approach Meta-analysis systematic review
摘要:
目的:評價SuperPATH入路和后外側入路全髖關節(jié)置換術(total hip arthroplasty,THA)治療髖部疾病的臨床療效。方法:應用計算機檢索Cochrane Library、Pubmed、Embase、Medline、CBM、CNKI建庫至2017年5月國內外公開發(fā)表的SuperPATH入路(SuperPATH入路組)與后外側入路(后外側入路組)THA療效比較的隨機對照研究文獻或觀察性研究文獻。由2位研究者獨立篩選文獻、提取資料,依據(jù)Cochrane手冊和NOS量表進行文獻方法學質量評價后,采用RevMan5.3軟件進行Meta分析。結果:最初檢出62篇相關文獻,經(jīng)篩選最終納入4篇文獻,均為中文文獻。3篇文獻為隨機對照研究文獻,均未提及具體的隨機方法,且均未詳細提及應用盲法; 1篇為觀察性研究文獻。納入的研究對象共266例,SuperPATH入路組120例、后外側入路組146例。Meta分析結果顯示,SuperPATH入路組的切口長度小于后外側入路組[SMD=-7.51,95%CI(-8.88,-6.13)]、術后臥床時間比后外側入路組短[SMD=-3.53,95%CI(-3.98,-3.07)]、住院時間比后外側入路組短[SMD=-2.54,95%CI(-4.50,-0.59)]; 2組的手術時間[SMD=0.68,95%CI(-0.17,1.54)]、術中出血量[SMD=-0.17,95%CI(-3.87,3.52)]、術后1個月Harris髖關節(jié)功能評分[SMD=0.17,95%CI(-0.29,0.63)]、術后3個月Harris髖關節(jié)功能評分[SMD=0.28,95%CI(-0.01,0.56)]、術后3個月雙下肢長度差值[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)計學意義。利用術后臥床時間及住院時間進行發(fā)表偏倚分析,漏斗圖顯示兩側基本對稱。結論:SuperPATH入路THA與后外側入路THA治療髖部疾病的臨床療效相當,但前者能夠顯著減少軟組織損傷,有利于患者快速康復。
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:
基金項目:浙江省自然科學基金資助項目(LY14H060001); 浙江省科技計劃項目(2017C33227); 浙江省湖州市科學技術局公益性應用研究項目(2016GY26) 通訊作者:閔繼康 E-mail:2149836631@qq.com
更新日期/Last Update: 2018-06-02