急性髌骨脱位非手术治疗与手术治疗的Meta分析  

Non-surgical methods versus surgical interventions for treating acute patellar dislocation:a meta-analysis

作　　者：刘数敬 喻瑛瑛 陆广旭 王文良 LIU Shujing;YU Yingying;LU Guangxu;WANG Wenliang(Graduate Team of Logistics University of PAP,Tianjin 300162,China;Featured Medical Center of Chinese People’s Armed Police Force,Tianjin 300162,China)

机构地区：[1]武警后勤学院研究生大队,天津300162 [2]武警特色医学中心关节二科,天津300162

出　　处：《武警医学》2019年第11期924-927,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：国家自然科学基金(30740089);武警部队项目(WHZ201607).

摘　　要：目的分析急性髌骨脱位患者手术治疗和非手术治疗的临床效果。方法计算机检索Pub Med、Embase、Springer、Cochrane图书馆、中国知网、谷歌学术等数据库(建库至2018年10月)中比较非手术和手术治疗急性髌骨脱位的临床随机对照研究,经过严格的质量评价后使用Rev Man 5.3软件进行Meta分析。临床指标为Kujala评分、脱位复发率、再次手术率。结果共纳入10篇文献。Meta分析结果显示:急性髌骨脱位两种治疗方法在Kujala评分和再次手术率方面差异无统计学意义,手术治疗组脱位复发率在短期随访组(RR=2.87,95%CI:1.75~4.69,P<0.0001)和长期随访组(RR=1.80,95%CI:1.62~3.03,P=0.03)均低于非手术治疗组。结论手术治疗急性髌骨脱位较非手术治疗不易复发;两组疗效在Kujala评分、再次手术率方面差异无统计学意义。Objective To compare the effectiveness of surgery with a non-surgical approach in the treatment of acute patellar dislocation by meta-analysis,and to help select the right clinical approach to acute patellar dislocation.Methods We searched Pub Med,Embase,Springer,Cochrane Library,China How Net and Google Academy for randomized controlled trials related to conservative approaches to and surgical treatment for acute patellar dislocation in the database(from database inception to October 2018).Meta-analysis was conducted using Rev Man 5.3 software after rigorous quality evaluation.Clinical indicators included the Kujala score,dislocation recurrence rate and reoperation rate.Results A total of 10 pieces of literature were included.The results showed that the Kujala score and reoperation rate were not of statistical significance.The recurrence rate of dislocation in the surgical treatment group was lower than that of the conservative treatment group both in the short-term follow-up group(RR=2.87,95%CI:1.75-4.69,P<0.0001)and in the long-term follow-up group(RR=1.80,95%CI:1.62-3.03,P=0.003).Conclusions Surgical treatment is less likely to lead to relapse than conservative treatment,but there is no significant difference in the Kujala score or reoperation rate between the conservative treatment group and surgical treatment group.

关 键 词：急性髌骨脱位 非手术治疗 手术治疗 META分析 

分 类 号：R687.3[医药卫生—骨科学]