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[1]王藝超,吳妞,袁慧敏,等.髓內(nèi)固定與髓外固定治療股骨轉(zhuǎn)子下骨折的系統(tǒng)評(píng)價(jià)[J].中醫(yī)正骨,2018,30(02):21-28.
　WANG Yichao,WU Niu,YUAN Huimin,et al.Intramedullary fixation versus extramedullary fixation for treatment of subtrochanteric fractures:A systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):21-28.
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髓內(nèi)固定與髓外固定治療股骨轉(zhuǎn)子下骨折的系統(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02期
頁(yè)碼:
21-28
欄目:
文獻(xiàn)研究
出版日期:
2018-02-20

文章信息/Info

Title:
Intramedullary fixation versus extramedullary fixation for treatment of subtrochanteric fractures:A systematic review
作者:
王藝超1; 吳妞2; 袁慧敏1; 張凱凱1; 劉晉閩3
1.浙江中醫(yī)藥大學(xué),浙江 杭州 310053; 2.成都中醫(yī)藥大學(xué),四川 成都 610075; 3.浙江省中醫(yī)院,浙江 杭州 310006
Author(s):
WANG Yichao1; WU Niu2; YUAN Huimin1; ZHANG Kaikai1; LIU Jinmin3
1.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 2.Chengdu Chinese Medical University,Chengdu 610075,Sichuan,China 3.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China
關(guān)鍵詞:
髖骨折;  股骨轉(zhuǎn)子下骨折;  骨折固定術(shù); 髓內(nèi);  髓外固定;  Meta分析;  系統(tǒng)評(píng)價(jià)
Keywords:
Keywords hip fractures;  subtrochanteric fractures;  fracture fixation; intramedullary;  extramedullary fixation;  meta-analysis;  systematic review
摘要:
目的:比較髓內(nèi)固定與髓外固定治療股骨轉(zhuǎn)子下骨折的臨床療效和安全性。方法:應(yīng)用計(jì)算機(jī)檢索PubMed、The Cochrane Library、Embase、CBM、CNKI、WanFang Data1980年9月至2017年9月國(guó)內(nèi)外公開發(fā)表的比較髓內(nèi)固定(髓內(nèi)固定組)和髓外固定(髓外固定組)治療股骨轉(zhuǎn)子下骨折的隨機(jī)對(duì)照研究文獻(xiàn)、半隨機(jī)對(duì)照研究文獻(xiàn)或回顧性研究文獻(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)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:最初共檢索出3410篇文獻(xiàn),經(jīng)逐層篩選后最終納入8篇文獻(xiàn),均為英文文獻(xiàn),5篇為隨機(jī)對(duì)照研究、2篇為半隨機(jī)對(duì)照研究、1篇為回顧性研究。納入的研究對(duì)象共391例,髓內(nèi)固定組225例、髓外固定組166例。Meta分析結(jié)果顯示,髓內(nèi)固定組和髓外固定組的手術(shù)時(shí)間、術(shù)中失血量、住院時(shí)間、術(shù)后感染率、再骨折率、骨折前及末次隨訪時(shí)的Parker活動(dòng)評(píng)分比較,組間差異均無(wú)統(tǒng)計(jì)學(xué)意義[WMD=3.87,95%CI(-1.95,9.70); WMD=-20.66,95%CI(-221.96,180.64); WMD=-2.95,95%CI(-7.16,1.25); RR=1.51,95%CI(0.57,3.98); RR=2.71,95%CI(0.72,10.15); WMD=-0.13,95%CI(-0.45,0.19); WMD=0.10,95%CI(-0.47,0.67)]; 與髓外固定組相比,髓內(nèi)固定組的術(shù)中透視時(shí)間長(zhǎng)[WMD=19.25,95%CI(8.75,29.75)]、再手術(shù)率低[RR=0.22,95%CI(0.09,0.55)]、內(nèi)固定失敗率低[RR=0.24,95%CI(0.10,0.56)]、骨折不愈合率低[RR=0.23,95%CI(0.07,0.81)]; 亞組分析顯示,老年(平均年齡≥50歲)股骨轉(zhuǎn)子下骨折患者采用髓內(nèi)固定的內(nèi)固定失敗率和骨折不愈合率更低[RR=0.18,95%CI(0.07,0.47); RR=0.22,95%CI(0.06,0.86)]。結(jié)論:與髓外固定相比,采用髓內(nèi)固定治療股骨轉(zhuǎn)子下骨折,內(nèi)固定失敗率、骨折不愈合率及再手術(shù)率較低,但術(shù)中透視時(shí)間較長(zhǎng)。老年股骨轉(zhuǎn)子下骨折患者更宜采用髓內(nèi)固定治療。
Abstract:
ABSTRACT Objective:To compare the curative effect and safety of intramedullary fixation versus extramedullary fixation for treatment of subtrochanteric fractures.Methods:All the randomized controlled trial(RCT)articles,controlled clinical trial(CCT)articles and retrospective trial articles about intramedullary fixation(intramedullary fixation group)versus extramedullary fixation(extramedullary fixation group)for treatment of subtrochanteric fractures that published at home and abroad included from September 1980 to September 2017 were retrieved from PubMed,The Cochrane Library,Embase,CBM,China national knowledge internet and WanFang Data 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 a Meta-analysis was conducted by using Revman 5.3 software.Results:Three thousand four hundred and ten articles were searched out.After screening,8 English articles(391 patients)were included in the final analysis,including 5 RCT articles,2 CCT articles and 1 retrospective trial article,225 patients in intramedullary fixation group and 166 patients in extramedullary fixation group.The results of Meta-analysis demonstrated that there was no statistical difference in operative time,intraoperative blood loss,hospital stay,postoperative

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備注/Memo

備注/Memo:
通訊作者:劉晉閩 E-mail:[email protected]
更新日期/Last Update: 2018-07-02