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[1]唐振坤,俞桂松,范奕松,等.骨填充網(wǎng)袋椎體成形術(shù)與經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體壓縮性骨折的Meta分析[J].中醫(yī)正骨,2019,31(10):31-36.
　TANG Zhenkun,YU Guisong,FAN Yisong,et al.Comparison of bone filling mesh container vertebroplasty versus percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(10):31-36.
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骨填充網(wǎng)袋椎體成形術(shù)與經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體壓縮性骨折的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年10期
頁碼:
31-36
欄目:
文獻(xiàn)研究
出版日期:
2019-10-20

文章信息/Info

Title:
Comparison of bone filling mesh container vertebroplasty versus percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta analysis
作者:
唐振坤1; 俞桂松1; 范奕松1; 蔣瑛翹1; 王藝超2; 劉晉閩3
(1.浙江中醫(yī)藥大學(xué)第一臨床醫(yī)學(xué)院,浙江 杭州 310053; 2.汝陽縣人民醫(yī)院,河南 汝陽 471200; 3.浙江省中醫(yī)院,浙江 杭州 310006)
Author(s):
TANG Zhenkun1; YU Guisong1; FAN Yisong1; JIANG Yingqiao1; WANG Yichao2; LIU Jinmin3
1.The First Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 2.The People's Hospital of Ruyang county,Ruyang 471200,Henan,China 3.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China
關(guān)鍵詞:
骨折; 壓縮性;  骨質(zhì)疏松性骨折;  椎體后凸成形術(shù);  骨填充網(wǎng)袋;  Meta分析;  系統(tǒng)評價
Keywords:
fractures; compression;  osteoporotic fractures;  kyphoplasty;  bone filling mesh container;  meta-analysis;  systematic review
摘要:
目的:比較骨填充網(wǎng)袋(bone filling mesh container,BFMCs)椎體成形術(shù)與經(jīng)皮椎體后凸成形術(shù)(percutaneous kyphoplasty,PKP)治療骨質(zhì)疏松性椎體壓縮性骨折(osteoporotic vertebral compression fracture,OVCF)的臨床療效和安全性。方法:應(yīng)用計算機(jī)檢索萬方、中國知網(wǎng)、維普、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、Pubmed數(shù)據(jù)庫從建庫至2019年5月15日國內(nèi)外公開發(fā)表的BFMCs椎體成形術(shù)(治療組)與PKP(對照組)治療OVCF的隨機(jī)對照臨床研究或回顧性臨床研究文獻(xiàn)。由2名研究者根據(jù)納入和排除標(biāo)準(zhǔn)獨立篩選文獻(xiàn)并提取資料,采用紐卡斯?fàn)?渥太華量表(the Newcastle-Ottawa scale,NOS)評價納入研究的文獻(xiàn)質(zhì)量,采用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果:最初檢索出51篇文獻(xiàn),通過閱讀標(biāo)題和摘要后剔除重復(fù)文獻(xiàn)30篇,剩余21篇經(jīng)過通讀全文后,最終納入5篇文獻(xiàn),均為中文文獻(xiàn)。1篇文獻(xiàn)比較了BFMCs椎體成形術(shù)、PKP、經(jīng)皮椎體成形術(shù)治療OVCF的療效,其余4篇文獻(xiàn)均比較BFMCs椎體成形術(shù)和PKP治療OVCF的療效。5篇文獻(xiàn)共涉及398例患者、443個傷椎,采用的手術(shù)入路均為椎弓根入路。2篇文獻(xiàn)NOS評分為8分,3篇文獻(xiàn)為7分。Meta分析結(jié)果顯示,治療組骨水泥滲漏率低于對照組[OR=0.13,95%CI(0.05,0.35)]; 2組傷椎前緣高度、Oswestry功能障礙指數(shù)、手術(shù)時間及術(shù)后即刻、術(shù)后3 d和術(shù)后1個月疼痛視覺模擬量表評分比較,組間差異均無統(tǒng)計學(xué)意義[MD=-0.28,95%CI(-1.32,0.77); MD=0.61,95%CI(-0.93,2.16); MD=-2.42,95%CI(-7.65,2.81); MD=0.42,95%CI(-0.92,1.76); MD=-0.01,95%CI(-0.24,0.23); MD=0.07,95%CI(-0.05,0.18)]。3篇文獻(xiàn)比較了2組OVCF患者治療后的Cobb角,2篇文獻(xiàn)比較了2組OVCF患者術(shù)中透視次數(shù),但因比較Cobb角的時間節(jié)點不同以及記錄術(shù)中透視次數(shù)的數(shù)據(jù)不統(tǒng)一,無法相互轉(zhuǎn)化,故均未對其進(jìn)行統(tǒng)計分析。結(jié)論:BFMCs椎體成形術(shù)和PKP治療OVCF,均能恢復(fù)椎體高度、緩解疼痛、促進(jìn)腰椎功能恢復(fù),二者的手術(shù)時間相當(dāng),但BFMCs椎體成形術(shù)在降低骨水泥滲漏率方面優(yōu)于PKP。
Abstract:
Objective:To compare the clinical curative effects and safety of bone filling mesh con-tainer(BFMCs)vertebroplasty versus percutaneous kyphoplasty(PKP)for treatment of osteoporotic vertebral compression fracture(OVCF).Methods:All the randomized controlled trial(RCT)articles and retrospective clinical trial articles about BFMCs vertebroplasty(treatment group)versus PKP(control group)for treatment of OVCF that published at home and abroad included from database establishing to May 15,2019 were retrieved from WanFang Database,China national knowledge internet,VIP Database,Chinese biomedical literature data-base and Pubmed Database through computer.The articles were screened and the information was extracted independently by two searchers according to the inclusion and exclusion criteria.The methodological quality of research in the articles was evaluated according to the Newcastle-Ottawa scale(NOS)and a Meta-analysis was conducted by using RevMan 5.3 software.Results:Fifty-one articles were searched out in the initial stage.After screening through reading titles and abstracts of the articles,30 repetitive articles were excluded,and after screening through reading the full texts of the remained articles in detail,5 Chinese articles were included in the final analysis.The curative effects were compared between BFMCs vertebroplasty,PKP and percutaneous vertebroplasty in 1 article,and were compared between BFMCs vertebroplasty and PKP in the other 4 articles.Three hundred and ninety-eight patients(443 injured vertebraes)were involved in the 5 articles,and all patients were treated through pedicle approaches.The NOS scores of 2 articles were 8 points and the NOS scores of 3 articles were 7 points.The results of Meta-analysis demonstrated that the incidence rate of bone cement leakage was lower in treatment group compared to control group(OR=0.13,95%CI(0.05,0.35)).There was no statistical difference in injured vertebrae anterior border height,Oswestry disability index(ODI),operative time and pain visual analogue scale(VAS)scores immediately after surgery and at 3 days and 1 month after the surgery between the 2 groups(MD=-0.28,95%CI(-1.32,0.77); MD=0.61,95%CI(-0.93,2.16); MD=-2.42,95%CI(-7.65,2.81); MD=0.42,95%CI(-0.92,1.76); MD=-0.01,95%CI(-0.24,0.23); MD=0.07,95%CI(-0.05,0.18)).The post-treatment Cobb angle of OVCF patients were compared between the 2 groups in 3 articles,and the frequency of intraoperative X-ray exposure for OVCF patients were compared between the 2 groups in 2 articles.The articles were inconsistent with each other in the timepoints for measuring Cobb angle and the data of frequency of intraoperative X-ray exposure,so they couldn't be merged for statistical analysis.Conclusion:Both BFMCs vertebroplasty and PKP can restore vertebral height,relieve pain and promote lumbar function recovery in treatment of OVCF,and they are similar to each other in operative time,while the former surpasses the latter in reducing incidence rate of bone cement leakage.

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通訊作者:劉晉閩 E-mail:[email protected](收稿日期:2019-08-10 本文編輯:時紅磊)
更新日期/Last Update: 2019-10-15